Device for depletion of the leukocyte content of blood and blood components

ABSTRACT

Devices for the depletion of leukocytes in blood products, preferably comprising an upstream porous element including means for removal of gels, at least one intermediate porous element including means for removal of microaggregates, and a downstream element including means for removal of leukocytes by both adsorption and filtration, preferably with at least one of the elements having been modified to a CWST in excess of 53 dynes/cm.

This application is a continuation-in-part of U.S. application Ser. No.07/110,413 filed on Oct. 20, 1987, now abandoned, and acontinuation-in-part of U.S. Application Ser. No. 07/218,169 filed onJuly 13, 1988, now abandoned, both of which are incorporated herein byreference.

TECHNICAL FIELD

This invention relates to a method for depleting the leukocyte contentof whole blood and products derived therefrom, particularly from humanpacked red blood cells including cells which have been stored prior totransfusion for any period up to their allowable storage period, and adevice for effecting that depletion.

BACKGROUND OF THE INVENTION

It has been the practice for 50 years or more to transfuse whole blood,and more recently blood components, from one or more donors to otherpersons. With the passage of time and accumulation of research andclinical data, transfusion practices have improved greatly. One aspectof current practice is that whole blood is rarely administered; rather,patients needing red blood cells are given packed red cells (hereinafterPRC), and patients needing platelets are given platelet concentrate.These components are separated from whole blood by centrifuging, theprocess providing, as a third product, plasma, from which various otheruseful components ar obtained.

In addition to the three above-listed components, whole blood containswhite blood cells (known collectively as leukocytes) of various types,of which the most important are granulocytes and lymphocytes. Whiteblood cells provide protection against bacterial and viral infection.

In the mid to late seventies, a number of investigators proposed thatgranulocytes be separated from donated blood and transfused intopatients who lacked them, for example, those whose own cells had beenoverwhelmed by an infection. In the resulting investigations, it becameapparent that this practice is generally harmful, since patientsreceiving such transfusion developed high fevers, had other adversereactions, and generally rejected the transfused cells. Further, thetransfusion of packed cells or whole blood containing donor leukocytescan be harmful to the recipient in other ways. Some of the viraldiseases induced by transfusion therapy, e.g., Cytomegaloviral InclusionDisease which is a life threatening infection to newborns anddebilitated adults, are transmitted by the infusion of homologousleukocytes. Another life-threatening phenomenon affectingimmunocompromised patients is Graft versus host disease (GVH); a diseasein which the transfused leukocytes actually cause irreversible damage tothe blood recipient's organs including the skin, gastrointestinal tractand neurological system. Conventional red cell transfusions have alsobeen indicted as adversely influencing the survival of patientsundergoing surgery for malignancy of the large intestine. It is believedthat this adverse effect is mediated by the transfusion of agents otherthan donor red blood cells including the donor's leukocytes.

Removal of leukocytes to sufficiently low levels to prevent theundesired reactions, particularly in packed red cells including thosewhich have been stored for relatively long periods of time, is anobjective of this invention.

In the currently used centrifugal methods for separating blood into thethree basic fractions (packed red cells, platelet concentrate, andplasma), the leukocytes are present in substantial quantities in boththe packed red cells and platelet concentrate fractions. It is nowgenerally accepted that it would be highly desirable to reduce theleukocyte concentration of these blood components to as low a level aspossible. While there is no firm criterion, it is generally acceptedthat many of the undesirable effects of transfusion would be adequatelyreduced if the leukocyte content were reduced by a factor of about 100or more prior to administration to the patient. This approximatesreducing the total content of leukocytes in a single unit of PRC (thequantity of PRC obtained from a single blood donation) to less than0.1×10⁹.

Defining a Unit of Blood, and a Unit of Packed Red Cells

Blood banks in the United States commonly draw about 450 milliliters(ml) of blood from the donor into a bag which usually contains ananticoagulant to prevent the blood from clotting. Herein the quantitydrawn during such a donation is defined as a unit of whole blood.

Whole blood is rarely used as such; instead most units are processedindividually by centrifugation or by gravity settling to produce oneunit of red cell concentrate in blood plasma, referred to herein as PRC(packed red cells). The volume of a unit of PRC varies considerablydependent on the hematocrit (percent by volume of red cells) of thedrawn blood, which is usually in the range of 37% to 54%; and thehematocrit of the PRC, which usually is in the range from 70% to 80%.Most PRC units are in the range of 250 to 300 ml, but variation belowand above these figures is not uncommon.

Drawn whole blood may alternatively be processed by separating the redcells from the plasma, and resuspending them in a physiologicalsolution. A number of physiological solutions are in use. The red cellsso processed may be stored for a longer period before use, and with somepatients there may be some advantages in the removal of plasma. "Adsol"is the trade name of one such system. Similar products are used inEurope and other parts of the world.

As used herein the term "blood product" includes anti-coagulated wholeblood, packed red cells obtained therefrom, and red cells separated fromplasma and resuspended in physiological fluid.

In parts of the world other than the United States, blood banks andhospitals may draw less or more than about 450 ml of blood; herein,however, a "unit" is herein defined by the United States' practice, anda unit of PRC or of red cells in physiological fluid is the quantityderived from one unit of whole blood.

As used herein, PRC refers to the blood product described above, and tosimilar blood products obtained by other means and with similarproperties.

Previously Available Means to Remove Leukocytes From PRC

The Spin-Filter system for obtaining leukocyte depleted packed red cellsis described by Parravicini, Rebulla, Apuzzo, Wenz and Sirchia inTransfusion 1984; 24:508-510, and is compared with other methods by Wenzin CRC Critical Reviews in Clinical Laboratory Sciences 1986; 24:1-20.This method is convenient and relatively inexpensive to perform; it hasbeen and continues to be used extensively. However, the efficiency ofleukocyte removal, while generally 90% or better, is not sufficientlyhigh to prevent adverse reactions in some patients.

Centrifugation methods are available which produce lower levels ofleukocytes in red cells, but these are laboratory procedures which arevery costly to operate, and sterility of the product is such that itmust be used within 24 hours.

Other methods for leukocyte depletion, such as saline washing ordeglycerolizing frozen red cells, have been or are used, but these havedisadvantages for economical, high reliability service, and cannot beused at bedside.

A number of devices have been proposed in which fibers are packed intohousings, and whole blood passed through them in order to removemicroaggregates and a portion of the white cell content. These deviceshave all required saline to be applied either before or after use, orboth before and after use. Further these devices have been poorly suitedfor use with PRC, in which they show early clogging and often or alwaysfail to remove leukocytes to below 0.1×10⁹ per unit of PRC or of wholeblood. None are ideal for bedside use.

Characteristics Desirable in a Leukocyte Depletion Device

An ideal device for leukocyte depletion use would be inexpensive,relatively small, and be capable of delivering blood to the patientwithin about 30 seconds after connection to the bag of red cells and thepatient's vein. The device should then deliver to the patient at leastone unit (the product of a single blood donation) of red cells in whichthe leukocyte content has been reduced to a total of no greater than1×10⁹, and preferably to a level of less than 0.1×10⁹. The capability ofdelivering a full second unit of packed red cells with maintenance ofthe high efficiency with respect to removal of leukocytes is alsodesirable. Further, because of the high cost and limited availability ofred blood cells, this ideal device would deliver the highest possibleproportion of the red cells originally present in the bag. The devicewould similarly be effective for blood products which have been storedfor a relatively long period of time, including up to the date beyondwhich its useful life will have expired. Such a device is an object ofthis invention.

Devices which have previously been developed in attempts to meet thisobjective have been based on the use of packed fibers, and havegenerally been referred to as filters. However, it would appear thatprocesses utilizing filtration based on separation by size cannotsucceed for two reasons. First, the various types of leukocytes rangefrom granulocytes and macrocytes, which can be larger than 15micrometers, to lymphocytes, which are in the 5 to 7 micrometer andlarger range. Together, granulocytes and lymphocytes represent the majorproportion of all of the leukocytes in normal blood. Red blood cells areabout 7 micrometers in diameter, i.e., in size between the two majorcomponents which must be removed. Secondly, all of these cells maydeform so as to pass through much smaller openings than their normalsize. Accordingly, and because it can be observed by microscopicexamination that leukocytes are adsorbed on a variety of surfaces, ithas been widely accepted that removal of leukocytes is accomplished byadsorption, rather than by filtration.

Attempts have been made to reduce leukocyte concentration in blood byexposure to a variety of surfaces, including polyamide, polyester,acrylics, cellulosics (e.g., cotton), cellulose acetate, and siliconizedglass wool. Fibrous devices available to this date have at best beenonly partially successful, for the reasons described below. As theproblems attendant on the earlier devices are reviewed, the manner inwhich the device and method in accordance with this invention aresuperior will become apparent.

Blood Component Recovery

In the preceding section, reference was made to the desirability ofrecovering a high proportion of the packed red cells delivered to theseparation device. There are several causes for reduced recovery of redcells:

(a) Losses due to hold up within the connecting tubing and the dripchamber;

(b) Losses due to liquid which remains within the device itself at theconclusion of the transfusion; and

(c) Losses due to adsorption on the surfaces of the device, or due tomechanical entrapment within the device.

(d) Loss due to clogging of the filter prior to completion of thepassages of one or two units of blood.

Losses due to cause (a) can be minimized by use of a device which inbedside use requires only to have its inlet connected to the blood bagand its outlet to a drip chamber connected to the patient's vein, thusavoiding the use of side connections which are, for example, required ifsaline is used for priming. Losses can be further reduced if the designof the device is such as to permit use of a relatively small dripchamber. Losses due to cause (b) are referred to generally, and arereported herein, as "hold-up volume" measured in milliliters. Losses dueto cause (c), if any, will be reported as due to adsorption. As forlosses due to cause (d), one of the objectives of this invention is adevice which does not clog, or which very rarely clogs, during theadministration of two units of PRC even if the PRC is at or near itspermissible storage life. More generally, an objective of this inventionis a leukocyte depletion device having the highest possible red cellrecovery.

Capacity

As separated from whole blood in current blood banking practice, packedred cells contain not only a proportion of the leukocytes present in theblood as drawn from the donor, but also some platelets (which tend to bevery adhesive), fibrinogen, fibrin strands, tiny fat globules, andnumerous other components normally present in small proportions. Alsocontained are factors added at the time the blood is drawn to preventclotting, and nutrients which help to preserve the red cells duringstorage.

During the centrifuging process which concentrates the red cells andpartially separates them from the remaining components, there is atendency for microaggregates to form in PRC. These may comprise some redcells together with leukocytes, platelets, fibrinogen, fibrin, and othercomponents. Gels, which may be formed by fibrinogen and/or fibrin, arefrequently present in PRC produced by blood banks.

The gels are somewhat viscous, and though liquid, form a separategelatinous phase in the blood plasma. Once segregated by filtration,gels may be identified in a spent filter by their tendency to cohere instringy forms when manipulated under a microscope at 30 to 50magnification.

Packed red cells can be refrigerated and stored for use within a periodof 21 to 42 days or more depending on the additive system used. ForCPDA-1 anti-coagulated PRC, the permissible storage period in the U.S.is 35 days. During storage, the number and size of the microaggregatesincrease with time. Further, gel-like bodies generally form which maycomprise fibrinogen, degenerated protein, and degenerated nucleic acids,and which often contain what appears on microscopic examination to beaggregates of leukocytes. Occasionally, small fat globules present inthe blood when drawn may coalesce to form larger globules.

If the leukocyte depletion device comprises a porous structure,microaggregates, gels and occasionally fat globules tend to collect onor within the pores, causing blockage which inhibits flow.

In hospital practice, bedside transfusions usually use gravity,developing no more than 0.1 to 0.14 kg/cm² to induce flow from thestorage bag through the leukocyte removal device to the patient. Forthis reason a particularly important characteristic of a separationdevice is its resistance to clogging.

Because of the unusual and highly variable combination of cloggingfactors, the experience of a person skilled in the art of filter designis inadequate when applied to removal of the undesirable componentslisted above from PRC, and novel, inventive approaches have beenrequired to design an efficient prefilter, particularly when the PRC hasbeen stored for a relatively long period of time.

The best of the devices on the market during the period of developmentof this invention was rated by its manufacturer to have a capacity forCPDA-1 anti-coagulated PRC of one unit, with a blood hold-up volume ofabout 64 cc. The same device was rated for use with two units of bloodproduct which had been freed of plasma by centrifuging and subsequentlyresuspended in a physiological solution. Predecessor devices by the samemanufacturer had a blood product hold-up volume of about 52 cc; however,this device is no longer being marketed and was replaced by the largerdevice because of excessive frequency of clogging.

Devices in accordance with this invention can be designed to deliver anyrequired number of units of PRC while maintaining an average removalefficiency greater than about 99.5%, preferably greater than about99.9%. However, such a unit, for example, one rated to process fourunits of PRC, might have an internal volume such that as much as 30 to50% of the red cells could be lost by hold-up within the device if itwere employed to process a single unit of PRC. Most commonly, one or twoPRC units are needed by a patient. Hence, a device sized to process asingle unit of PRC with greater than 99.9% efficiency, but capable ofpassing a second unit while maintaining high efficiency, is seen to be avery useful and economical size, and has been selected as a primaryobjective of this invention. As discussed below, unless otherwisestated, it is this size of device (which will be referred to as an"adult" size) to which reference is being made.

While the devices described herein are principally directed to theprimary objective described above, by proportionally changing thedimensions, equipment suitable for use with larger or smaller quantitiesof PRC can be made. A version of the device in accordance with thisinvention, designated as a "pediatric" size, with approximately one-halfthe area and hence one-half the capacity of the adult device, has beenextensively used during development of this invention, for reasons ofeconomy of whole blood and PRC used for testing, and because there isneed for such a unit in hospital practice.

The microaggregates which cause clogging vary in size from about 200micrometers down, and vary in quantity and size distribution with age,as well as randomly from one unit of packed red cells to the next. Thegels vary with respect to both firmness and quantity. Large fat globulesappear in a small but significant proportion of packed red cellspecimens. Hematocrit (percent by volume of red cells) and viscosity caneach vary over a wide range. This variability in characteristics makesthe causes and onset of clogging extremely variable from one unit ofblood to the next. Under these circumstances, while the development of aprefilter draws in part on science and on experience common to thosefamiliar with the field of filtration, there is a large component ofchance and intuition in the achievement of an effective prefilter.

The design of an efficient, small volume gel prefilter system which willcontribute to the objective of achieving high efficiency of leukocyteremoval while rarely or never clogging on one unit of packed red cellsand which will pass all of two units in the great majority of cases, beit with newly drawn or with older blood, is an objective of thisinvention.

For an important class of patients, namely those such as thalassemicswho are dependent on regularly repeated transfusions in order tomaintain life, physicians recognize a special need for high efficiencyleukocyte removal, and for the use of relatively fresh PRC. Iftransfused with PRC which is less than five days old, thalassemicsrequire two or three units of PRC at 3 week intervals, however, if olderPRC is used, transfusion at more frequent intervals is needed. Somephysicians whose patient roster includes thalassemics will not use bloodolder than 5 days. For such applications the gel and microaggregateremoval characteristics of the filter are less critical, and a filtercan be designed to have a smaller hold up of PRC, and to be produced atless cost.

For the more general application in which a very significant proportionof the PRC is stored for more than 15 to 35 days or more prior to use,it is critical that the filter reliably deliver its stated capacity witha frequency near to 100% while maintaining high efficiency and low holdup. Failure to complete passage of a second unit is costly in terms ofPRC lost, in the time of the nurse-technician and the physician, and canbe harmful to the patient.

Accordingly, the products of this invention are directed to use withboth fresh and older PRC.

Ease and Rapidity of Priming

Ease of use is an important characteristic of any leukocyte depletionsystem. As noted above, for leukocyte depletion devices, ease of primingis a particularly important factor. The term "priming" refers tostart-up of flow of PRC from the bag through the filter to the dripchamber. An object of this invention is to keep that time to below about30 seconds. A short priming period is always desirable to conservenurse/technician time, but can be life saving when quick administrationis required as, for example, when serious blood loss is unexpectedlyexperienced during surgery.

Preconditioninq of Leukocyte Depletion Devices Prior to Priming

A number of devices in current use require pretreatment prior to passingblood, usually consisting of passing physiological saline, which may ormay not be delivered to the patient's vein.

The necessity for such an operation is clearly very undesirable, for thereasons set out in the preceding section.

The reasons for using such pretreatment vary. They include removal ofacid hydrolysate developed during steam sterilization of devicescontaining cellulose acetate fibers, assurance of freedom from foreignsolids which may be present in natural fibers, and if the fibers arehygroscopic, to prevent hemolysis (loss of the integrity of red bloodcells with subsequent loss of their contents to the external milieu).

An objective of this invention is a leukocyte depletion device whichrequires no preconditioning prior to bedside use.

Definition of Pore Diameter

Below 25 micrometers "pore diameter" is as determined by the modifiedOSU F2 test described in the section headed Examples. Above 25micrometers, microscopic observation was used to estimate theapproximate diameter of spherical particle which would be retained by aporous medium.

Definition of Element and of Integral Element

The word "element" as used above, and generally as used herein, denotesa portion of the overall assembly which consists of porous web in theform of one or more layers which may or may not be bonded to each other,but which performs a defined function within the filter assembly. Eachof the layers is preformed, usually by hot compression, to controlleddensity and pore size, either as a single layer, or in combination withone or more other layers.

The expression "integral element" denotes a portion of the overallassembly which contains one or more layers of porous web, with (if thereare more than one) the layers bonded to each other. An integral elementis a unitary, complete structure having its own integrity,self-contained and independent of the other elements until assembled.

Wetting of Fibrous Media

When a liquid is brought into contact with the upstream surface of aporous medium and a small pressure differential is applied, flow intoand through the porous medium may or may not occur. A condition in whichno flow occurs is that in which the liquid does not wet the material ofwhich the porous structure is made.

A series of liquids can be prepared, each with a surface tension ofabout 3 dynes/cm higher compared with the one preceding. A drop of eachmay then be placed on a porous surface and observed to determine whetherit is absorbed quickly, or remains on the surface. For example, applyingthis technique to a 0.2 micrometer porous polytetrafluoroethylene (PTFE)filter sheet, instant wetting was observed for a liquid with a surfacetension of 26 dynes/cm. However, the structure remained unwetted when aliquid with a surface tension of 29 dynes/cm was applied.

Similar behavior is observed for porous media made using other syntheticresins, with the wet-unwet values dependent principally on the surfacecharacteristics of the material from which the porous medium is made,and secondarily, on the pore size characteristics of the porous medium.For example, fibrous polyester (specifically polybutylene terephthalate(hereinafter "PBT") sheets) which have pore diameters less than abouttwenty micrometers were wetted by a liquid with a surface tension of 50dynes/cm, but were not wetted by a liquid with a surface tension of 54dynes/cm.

In order to characterize this behavior of a porous medium, the term"critical wetting surface tension" (CWST) has been defined as describedbelow. The CWST of a porous medium may be determined by individuallyapplying to its surface, preferably dropwise, a series of liquids withsurface tensions varying by 2 to 4 dynes/cm, and observing theabsorption or non-absorption of each liquid. The CWST of a porousmedium, in units of dynes/cm, is defined as the mean value of thesurface tension of the liquid which is absorbed and that of a liquid ofneighboring surface tension which is not absorbed. Thus, in the examplesof the two preceding paragraphs, the CWST's were respectively 27.5 and52 dynes/cm.

In measuring CWST, a series of standard liquids for testing are preparedwith surface tensions varying in a sequential manner by 2 to 4 dynes/cm.Ten drops of each of at least two of the sequential surface tensionstandard liquids are independently placed on representative portions ofthe porous medium and allowed to stand for 10 minutes. Observation ismade after 10 minutes. Wetting is defined as absorption into or obviouswetting of the porous medium by at least nine of the ten drops within 10minutes. Non-wetting is defined by non-absorption or non-wetting of atleast nine of the ten drops in 10 minutes. Testing is continued usingliquids of successively higher or lower surface tension, until a pairhas been identified, one wetting and one non-wetting, which are the mostclosely spaced in surface tension. The CWST is then within that rangeand, for convenience, the average of the two surface tensions is used asa single number to specify the CWST.

Appropriate solutions with varying surface tension can be prepared in avariety of ways, however, those used in the development of the productdescribed herein were:

Wetting of Fibrous Media by Blood

In packed red cells, as well as in whole blood, the red cells aresuspended in blood plasma, which has a surface tension of 73 dynes/cm.Hence, if packed red cells or whole blood is placed in contact with aporous medium, spontaneous wetting will occur if the porous medium has aCWST of 73 dynes/cm or higher.

Hematocrit is the percent by volume occupied by red cells. Thehematocrit of packed red cells usually ranges from 70 to 80%. Thus, 70to 80% of the volume of packed red cells consists of the red cellsthemselves and, for this reason, the surface characteristics of the redcells influence the wetting behavior of PRC. This is also true for wholeblood, in which the normal hematocrit ranges from 37 to 54%. The surfacetension of the red cell surfaces is given in the literature as 64.5dynes/cm. ("Measurement of Surface Tensions of Blood Cells & Proteins",by A.W. Neumann et al., from Annals N.Y.A.S., 1983, pp. 276-297.)

The benefits conferred by preconditioning fibers to CWST values higherthan the natural CWST of synthetic fibers include:

(a) When priming for any reason is done using lower pressures than the0.2 kg/cm² used in this study, for example by gravity, the time toachieve priming is significantly reduced. At 0.2 kg/cm², the reductionis, however, so small as to be difficult to measure.

(b) An important aspect of this invention is the discovery that fibrousmedia treated to convert the fiber surfaces to a particular range ofCWST perform better with respect to time required for priming,efficiency and resistance to clogging than do fibrous media with CWSTvalues outside of those ranges.

(c) Synthetic fiber media whose CWST values have been elevated bygrafting have superior fiber to fiber bonding and are for this reasonpreferred for use in making the preformed elements used in thisinvention.

(d) Portions of unmodified filters may remain unwetted, therebyinhibiting flow through those areas.

(e) Devices made using unmodified synthetic fibers are recommended bytheir manufacturers to be flushed with saline prior to use. Thisoperation is undesirable since it causes blood loss due to hold-upwithin the complex tubing arrangement required, adds to cost, operationtime, and operation complexity, and increases the probability thatsterility may be lost.

(f) Blood has been observed to clot when exposed to unmodified syntheticfibers.

DISCLOSURE OF THE INVENTION:

In accordance with the subject invention, a device and method fordepleting the leukocyte content of a blood product is provided.

The subject invention provides a device for the depletion of theleukocyte content of a blood product comprising at least first, second,and third preformed porous elements with the second element interposedbetween the first and third elements, each successive element having asmaller pore diameter than that preceding it, the first elementincluding means for removing gels, the second element including meansfor removing microaggregates, and the third element including means forremoving leukocytes.

This first device can have a third element which has a pore diameter inthe range from about 4 to about 8 micrometers. For example, the thirdelement can have a pore diameter in the range from about 4 to about 5.5micrometers, the first device then being well suited for processing ablood product having an age of about 2 to about 5 to 10 days, or thethird element can have a pore diameter in the range from about 6 toabout 8 micrometers, the first device then being well suited forprocessing a blood product having an age in excess of about 10 or 15days.

The first device can have a first element which comprises a needledfibrous structure. The first element can be hot compressed to acontrolled thickness. The average pore diameter of the first element canbe such as to require, when prewetted by isopropyl alcohol, adifferential pressure of 4 to 7 cm of water column to induce air flowthrough it at the rate of 0.5 cm/second through the first element.

The first device can include at least two interposed elements comprisedof porous media which in at least three steps span in approximategeometric progression the pore diameter range from about 25 to about 10micrometers.

The first device can include at least two interposed elements comprisedof porous media which have progressively stepwise decreasing porediameters spanning the range from about 25 to about 10 micrometers.

The first device can include a single interposed element in which thepore diameter varies stepwise from about 25 micrometers down to a porediameter in the range from about 10 to about 15 micrometers.

The first device can include a surfactant which has been added to one ormore of the elements. The surfactant can have characteristics whichinduce a surface tension in the range of about 55 to 45 dynes/cm in ablood product processed through it.

The first device can have at least one element which has been modifiedto a CWST in excess of 53 dynes/cm. For example, at least one of theelements can be modified to a CWST in excess of about 59 dynes/cm or atleast one of the elements can be modified to a CWST in excess of 63dynes/cm. Alternatively, at least one of the elements can be modified toa CWST in the range from about 55 to about 75 dynes/cm. For example, atleast one of the elements can be modified to a CWST in the range fromabout 55 to about 75 dynes/cm. As a further alternative, at least one ofthe elements can be surface modified by exposure to an energy sourcewhile in contact with a monomer containing at least one hydroxyl moietyand one moiety capable of activation by an energy source, together witha monomer containing at least one hydrophobic moiety and one moietycapable of activation by an energy source.

The first device can include first, second, and third elements eachhaving an effective cross-sectional area which is in excess of 54 squarecm. Further, the total voids volume in all of the elements can be lessthan 28 milliliters. The total internal voids volume of the first devicecan be less than 37 milliliters.

The first device can have a third element in which the means forremoving leukocytes includes a filtration means.

The subject invention also provides a device for the depletion of theleukocyte content of a blood product comprising at least first, second,and third porous elements with the second element interposed between thefirst and third elements, each successive element having a smaller porediameter than that preceding it, the first element including means forremoving gels, the second element including means for removingmicroaggregates, the third element including means for removingleukocytes, and at least one of the elements having been modified to aCWST in excess of 53 dynes/cm.

This second device can have all of the elements compressed to acontrolled thickness prior to assembly.

The second device can consistently provide prior to clogging a capacityof at least two units of blood product of any age up to and includingits permissible limit for human use. At least one of the componentelements can be compressed to a controlled thickness prior to assembly.The total voids volume of all the elements can be less than 28milliliters and the total internal voids volume of the second device canbe less than 37 milliliters. The porous elements can be fibrous and thetotal surface area of all of the fibers can be less than 4 squaremeters. With the total surface area of all the fibers being less than 4square meters, the pore diameter of the third element can be in therange of 4 to 8 micrometers. The total surface area of all the fibersalternatively can be less than 3.5 square meters. With the total surfacearea of all the fibers less than 3.5 square meters, the pore diameter ofthe third element can be in the range from about 4 to about 8micrometers.

The second device can have at least one of the elements compressed to acontrolled thickness prior to assembly.

Devices in accordance with this invention, including the first andsecond devices described above, can include a first element which hastwo or more means for removing gels.

The subject invention further provides a device for the depletion of theleukocyte content of a blood product comprising at least one integralelement preformed of synthetic fibers, the surface of the fibers havinga modified CWST in excess of 53 dynes/cm.

This third device can have synthetic fibers which have been surfacemodified to increase their CWST by 2 or more dynes/cm.

The third device can have a CWST in excess of 59 dynes/cm. For example,the CWST can be in excess of 63 dynes/cm.

The third device can have fibers which have been surface modified byexposure to an energy source while in contact with a monomer containingat least one hydroxyl moiety and one moiety capable of activation by anenergy source, together with a monomer containing at least onehydrophobic moiety and one moiety capable of activation by an energysource.

The subject invention additionally provides a device for depletion ofleukocytes from a blood product comprising at least one element in whicha fibrous medium has been radiation grafted to obtain a critical wettingsurface tension in excess of 53 dynes/cm and thereafter hot compressedto form a non-friable coherent body.

This fourth device can have the element modified to a CWST in the rangeof about 55 to 75 dynes/cm.

The fourth device can have the fibrous surface modified by exposure toan energy source while in contact with a monomer containing at least onehydroxyl moiety and one moiety capable of activation by an energysource, together with a monomer containing at least one hydrophobicmoiety and one moiety capable of activation by an energy source.

The subject invention additionally provides a device for the depletionof the leukocyte content of a blood product comprising at least onintegral, preformed element of synthetic fibers including means forremoving leukocytes.

This fifth device can have the synthetic fibers modified to a CWST inthe range of about 55 to 75 dynes/cm.

The fifth device can have the fibrous surface modified by exposure to anenergy source while in contact with a monomer containing at least onehydroxyl moiety and one moiety capable of activation by an energysource, together with a monomer containing at least one hydrophobicmoiety and one moiety capable of activation by an energy source.

The subject invention also provides a device for the depletion of thegel content of a liquid phase prior to filtration and thereby extendingthe capacity of a filter assembly, comprising at least first and secondporous elements, the first element composed at least in part of aneedled fibrous web and the second element having a smaller pore sizethan the first.

This sixth device can deplete the gel content of a liquid phase which isa blood product. The average pore diameter of the first element can besuch as to require, when prewetted by isopropyl alcohol, a differentialpressure of 4 to 7 cm of water column to induce flow of air through itat a rate of 0.5 cm/second through the first element. The effective flowpath can comprise, in part, three or more elements preformed prior toassembly, each with cross-sectional flow area in excess of 54 squarecentimeters. The total voids volume of all the elements can be less than28 milliliters and the total internal voids volume can be less than 37milliliters.

The sixth device can have a second element which comprises at least oneplanar parallel non-woven component. A third element can be includedwith the second element disposed between the first and the thirdelements, at least one of the second and third elements being modifiedto a CWST within about 2 to 20 dynes/cm of the surface tension of theliquid phase. This consistently provides prior to clogging a capacity ofat least two units of a blood product of any age up to and including itspermissible limit for human use. The total voids volume of all theelements can be less than 28 milliliters and the total voids volume ofthe device can be less than 37 milliliters. At least one of the secondand third elements can be modified to a CWST in the range of about 55 toabout 75 dynes/cm.

The sixth device can have at least one of the component elementscompressed to a controlled thickness prior to assembly. For example, allof the component elements can be compressed to a controlled thicknessprior to assembly.

The sixth device can include a second element which has been surfacemodified by exposure to an energy source while in contact with a monomercontaining at least one hydroxyl moiety and one moiety capable ofactivation by an energy source, together with a monomer containing atleast one hydrophobic moiety and a moiety capable of activation by anenergy source.

The subject invention also provides a device for the depletion of theleukocyte content of a blood product comprising a housing including aninlet and an outlet and defining a fluid flow path between the inlet andthe outlet, an upstream porous element, at least one intermediate porouselement, and a downstream porous element, the upstream element includingmeans for removing gels, the intermediate element including means forremoving microaggregate, and the downstream element including means forremoving leukocytes, the upstream, intermediate, and downstream elementsbeing secured within the housing by an interference fit.

The subject invention additionally provides a device for separating oneor more substances for a fluid to be administered to a patient, thedevice comprising a housing including an inlet and an outlet anddefining a fluid flow path between the inlet and the outlet and aseparating element disposed within the housing across the fluid flowpathand including a downstream surface, wherein the inlet communicates withthe housing near the bottom of the housing and upstream from theseparating element and wherein the housing further includes passagemeans for allowing air in the fluid to separate from the fluid, thepassage means being disposed downstream from the separating element andcommunicating with the outlet near the top of the housing.

This eighth device can have a housing which includes a wall facing thedownstream surface of the separating element and defining a plenum andcan include a passage means having a slot disposed in the wall andcommunicating between the plenum and the outlet, the slot being deeperthan the plenum. The wall can include a plurality of concentric circulargrooves which communicate with the slot. The slot can extend from thebottom to the top of the housing and the depth of the slot can increasefrom the bottom to the top of the housing. The slot length can be from50 to 80% of the inner diameter of the housing, and the slot can extendto the top of the housing. The slot depth can increase towards the topof the housing. The housing can have a generally circular configurationand the slot can extend from the top of the housing along at least aportion of the vertical inner diameter of the housing.

The subject invention provides a device for separating one or moresubstances from a fluid to be administered to a patient, the devicecomprising a generally housing including an inlet and an outlet anddefining a fluid flow path between the inlet and the outlet and a discshaped separation element disposed within the housing and havingupstream and downstream surfaces, wherein the housing further includesan inlet section facing the upstream surface of the separating elementand defining an inlet plenum, the inlet including a ridge extendingvertically along the exterior of the inlet section and a passagewaywhich opens at the top of the inlet ridge, extends through the inletridge, and communicates with the inlet plenum at the bottom of thehousing, and an outlet section facing the downstream surface of theseparating element and defining an outlet plenum and including a slotwhich is deeper than the outlet plenum and which communicates betweenthe outlet plenum and the outlet, the outlet including a ridge extendingvertically along the exterior of the outlet section and a passagewaywhich opens at the bottom of the outlet ridge, extends through theoutlet ridge, and communicates with the slot near the top of thehousing.

This ninth device can include an inlet section having a plurality ofconcentric circular grooves and an access extending between the inletpassageway and each circular groove, the circular grooves and the accesscollectively defining the inlet plenum and the inlet plenum having adepth which is greatest at the bottom of the housing near the inletpassageway.

The ninth device can include an outlet section having a plurality ofconcentric circular grooves which communicate with the slot, the slotextending from near the bottom of the housing to the top of the housingand having a greater depth at the top of the housing than at the bottom.

The ninth device can have a housing which further includes a cylindricalcollar disposed about the periphery of the disc shaped separationelement, the disc shaped separation element being sealed to thecylindrical collar by an interference fit between them.

The present invention further provides a method for the depletion of theleukocyte content of a blood product, for the depletion of the gelcontent of a liquid phase, or for separating one or more substances froma fluid to be administered to a patient, comprising passing the bloodproduct, liquid phase, or fluid through the appropriate devicesdescribed above.

The present invention also provides a method for the depletion of thegel content of a liquid comprising passing the liquid through a needledfibrous web. A preferred liquid and such a method is a blood product,particularly PRC.

The present invention additionally provides a method for determining thewetting characteristic of a porous medium comprising applying at leastone or more drops of each of at least two different liquids havingdifferent but closely spaced surface tensions to different locations onthe porous medium and if necessary repeating this process until, of twoliquids with neighboring surface tension, one is absorbed into themedium, and the other is not.

Significant and novel features of this invention which contribute toachieving high efficiency and capacity for leukocyte removal, andminimize loss of blood within the apparatus include:

(a) Previously disclosed devices have used relatively small crosssectional area perpendicular to the flow path, and as a consequence theliquid flow path through the filter medium is relatively longer. Thepreferred devices in accordance with this invention are larger in crosssectional area perpendicular to the flow path and correspondingly theflow path through the filter medium is shorter. The larger filter areaat the upstream surface so obtained helps to prevent clogging by PRC orblood containing relatively large quantities of gels andmicroaggregates.

(b) In order to make the larger cross sectional area economic andpractical and to obtain the required degree of prefiltration, each ofthe porous components of the preferred device in accordance with thisinvention is preformed prior to assembly to closely controlled dimensionand density to form in whole or in part an integral element,self-contained and independent of other elements until assembled into adevice in accordance with the subject invention.

Due to the pressure developed by the packing in devices utilizing packedfibers, devices used hitherto have had smaller cross-section and greaterdepth than the products of this invention. Preforming eliminates thepressure on the inlet and outlet faces of the housing which are inherentin a packed fiber system, preforming also permits one element, forexample, the first stage prefilter of the assembled device, to be moreor less compressible, yet have a lower or higher density than the onefollowing it. This arrangement contributes to longer life in service.

By permitting the use of thinner walled injection molded housings,preforming makes it more practical to use larger cross sectional arealeukocyte depletion devices which have longer life in service, coupledwith at least equal and usually better leukocyte removal efficiency,equal or better red cell recovery, and less hold up, when compared withdevices that use fibers or fibrous webs packed into a housing atassemblY. Preforming also contributes greatly to reduction of theinternal volume of the filter assembly, thus reducing blood loss due tohold-up within the filter assembly, to higher removal efficiency, and tothe ability to process a larger volume of PRC prior to clogging.

Devices have been disclosed and some made which incorporate variouscommercially made woven and non-woven media as prefilters along with amore finely pored last stage consisting of fibrous mats, all packedwithin a plastic housing. These devices have not had the efficientprefiltration and filtration made possible by preforming. None of themhave used preformed elements, nor have they used any means equal inresult to hot preforming, which achieves efficient pore diameters athigher densities, hence for equal results occupies less volume and holdsup less blood. This is reflected in the comparative performance of thedevice now marketed which comes closest to matching the products of thisinvention; that device uses melt blown fibrous web readily identifiableas being in the form in which it comes off the machine, hence notpreformed by any method. That product, compared with the product of thisinvention, has about twice the hold-up volume, has significantly lowerefficiency, and in the United States is rated to pass only one unit ofPRC, compared with two.

(c) The preformed element located in the upstream position of theassembly of preformed fibrous elements, hereinafter referred to as the"gel prefilter", has as its principal function the removal of gels whichare present in a substantial proportion of the PRC units supplied by theblood banks. The extraordinarily effective gel prefilter makes possiblethe use of devices with a smaller internal volume, with less blood lossdue to internal hold-up.

While the gel content of any specific unit of PRC is difficult toquantify, it is nevertheless readily apparent to one familiar with theart that PRC which has been stored more than 10 to 15 days, containssubstantially more gels than does PRC stored for less than 5 days. Asthe gel content increases, so must the volume of the gel prefilterprovided to remove and contain the gels. In this invention, we haveprovided two types of gel prefilter, one comprising a single layer foruse with relatively fresh PRC, and a second comprising two or morelayers for use with older PRC. Filter assemblies fitted with the singlelayer when used with fresh PRC will always deliver one unit of PRC, andonly rarely fail to deliver a second unit prior to clogging. Themulti-layer gel prefilter performs similarly for older blood near to orat its out-date limit. These gel prefilters constitute an importantaspect of this invention.

(d) While the gel prefilter is extremely efficient in removing gels witha very small increase in pressure drop, and removes as wellmicroaggregates which frequently are present suspended in the gels, itremoves at best only a small portion of the microaggregates which arenot contained within the gels.

Removal of these freely suspended microaggregates is accomplished byone, two, or more layers of prefiltration using filter media ofsuccessively smaller pore diameter, and these are followed by a layerwhose primary purpose is to remove leukocytes, sometimes denoted hereinas the "adsorption element". The resulting fluid delivered to thedownstream element is substantially free of gels and microaggregates andhas been partially freed of leukocytes.

(e) A surprising discovery was that the downstream (adsorption, or forbrevity, "last") element removes leukocytes from the suspension by twomechanisms, both operating simultaneously. One mechanism is byadsorption of leukocytes to the fibrous surfaces; the second is byfiltration. The first mechanisms cited is effective by virtue of thequantity of fiber surface. The second mechanism depends principally uponmaintaining the pore diameter of the filter medium within or below aspecific range.

(f) Modification of the fiber surfaces, to promote easy wetting by thePRC. Priming of the filter, i.e., inducing flow of PRC through it, ismore complex and more difficult than would appear at first sight.

If the CWST of the fiber surface is too low, for example that ofunmodified synthetic fiber, relatively higher pressure is required toforce the PRC to flow through. More seriously, areas of the filtermedium tend to remain unwetted, preventing flow of PRC. Further,clotting may occur, especially with finer, high surface area fibers andwith older blood.

For reasons which are not well understood, some filters which have CWSTin excess of about 90 dynes/cm have been observed to have longer primingtimes. Since there appears to be no theoretical reason for the CWST ofthe filter media to greatly exceed the surface tension of water (73dynes/cm) it appears advisable that the CWST be held within a rangesomewhat above the CWST of untreated polyester fiber (52 dynes/cm), andbelow about 75 dynes/cm. Nevertheless, filters with CWST in the range upto and over 90 dynes/cm and above have functioned well.

(g) The housing into which the element assembly is sealed is uniquelydesigned to achieve convenience of use, rapid priming, and efficient airclearance, this last leading to improved efficiency, longer servicelife, and further reduction in hold-up of PRC.

(h) The lateral dimensions of the elements are larger than thecorresponding inner dimensions of the housing into which they areassembled. For example, if the elements are of disc form, the discoutside diameter is made 0.1 to 1% larger than the housing insidediameter. This provides very effective sealing by forming aninterference fit with no loss of effective area of the elements, andcontributes further towards minimization of the blood hold-up volume ofthe assembly, compared with a compression seal around the periphery ofthe filter element assembly, which blocks flow in the compressed area.

BRIEF DESCRIPTION OF THE DRAWINGS:

FIG. 1 is a cross sectional view of an exemplary depletion deviceembodying the present invention.

FIG. 2 is an elevation view of the inside surface of the inlet sectionof the depletion device shown in FIG. 1.

FIG. 3 is an elevation view of the inside surface of the outlet sectionof the depletion device shown in FIG. 1.

FIG. 4 is a cross sectional view of the outlet section shown in FIG. 3.

BEST MODE FOR CARRYING OUT THE INVENTION: Material for Use inConstruction of Leukocyte Removal Devices

A variety of starting materials other than fibers can be considered; forexample, porous media could be cast from resin solution to make porousmembranes, or sintered powder media could be used. However,considerations of cost, convenience, flexibility, and ease offabrication and control, point to fibers as a preferred startingmaterial

In order to achieve good priming with the fibrous medium fully wettedand in the absence of surfactant deliberately added to reduce thesurface tension of the blood product, it would appear at first glancefrom elementary consideration of the physical chemistry involved thatblood component devices should be made of materials which have CWSTvalues about equal to the surface tension of water, for example in therange of 70 to 75 dynes/cm or higher. Practical considerations dictatethe use of commercially available fibers. Synthetic resins from whichfibers are prepared commercially include polyvinylidene fluoride,polyethylene, polypropylene, cellulose acetate, Nylon 6 and 66,polyester, polyacrylonitrile, and polyaramid. An importantcharacteristic of resins is their critical surface tension (Zisman,"Contact angles, wettability and adhesion", Adv. Chem. Ser. 43, 1-51,1964). These resins have critical surface tensions (γ_(c)) ranging fromless than 25 up to 45 dynes/cm. Experience has shown that the CWST offilter media in the pore size range needed for the products of thisinvention can be expected to be less than about 10 dynes/cm higher thanthe γ_(c) value of the solid plastic. For example, forpolytetrafluoroethylene, γ_(c) is 18 and CWST is 27.5, while for apolyester PBT fibrous mat, γ_(c) is 45, and CWST is 52. No suitablecommercially available synthetic fiber has been found which has a CWSThigher than about 52 dynes/cm.

In U.S. bedside transfusion practice, PRC is administered at a rate suchthat two units are infused over 1.5 to 4 hours. We have observed thatwhen an unmodified melt blown polyester is used as a filter, clotting ofthe PRC can occur within a 2 to 3 hour period, completely blocking thefilter.

Some natural fibers have CWST greater than 52, but natural fiberssmaller than about 15 micrometers in diameter are not generallycommercially available. Synthetic fiber webs which are less than about 5micrometers in diameter can be made by the melt blowing process, andcompared with natural fibers, such fibers require one third or less themass to provide equal fiber surface area for adsorption of leukocytes,and consequently, occupy less volume when fabricated into filters of agiven pore diameter. For this reason, natural fibers are not well suitedfor manufacturing leukocyte removal devices with optimally low hold-upvolume. For example, a commercially available packed cotton fiber devicecurrently used for leukocyte depletion has a priming volume of over 75ml, which is more than twice the volume of the preferred adult devicedescribed in this application. Furthermore, the makers of this devicerequire saline to be passed before and after the PRC has been passed,and the device is not suitable for bedside use. Additionally, blood soprocessed must be used within 24 hours.

The art of surface grafting has been the subject of extensive researchfor 25 years or more. Numerous publications in the scientific literatureand a large number of patents describe a variety of methods andprocedures for accomplishing surface modification by this means. Onesuch method employs a variety of monomers comprising an acrylic moietytogether with a second group which can be selected to vary fromhydrophilic (e.g., --COOH or --OH) to hydrophobic (e.g., saturatedchains such as --CH₂ CH₂ CH₃), and these have been used in the processof this invention. Heat, UV, and other reaction energizing methods canbe used to initiate and complete the reaction. However, cobalt sourceradiation grafting has been selected as most convenient and has beenused in this invention to modify the CWST of fibrous mats. By cut andtry selection, mixtures of monomers or single monomers can be foundwhich will produce a fibrous mat of polybutylene terephthalate in whichthe CWST has been increased from 52 to any desired value up to as highas is possible to be measured by the method described above. The upperlimit is set by the paucity of liquids with surface tensions at roomtemperature higher than about 110 dynes/cm.

During the development of this invention, devices were prepared usingmedia in which grafting was accomplished by compounds containing anethylenically unsaturated group, such as an acrylic moiety combined witha hydroxyl group (for example, 2-hydroxyethyl methacrylate, or "HEMA").A second acrylic monomer, such as methyl acrylate (MA) or methylmethacrylate (MMA), which tend to cause the grafted porous webs to havelower CWST, can be used in combination with HEMA, and by varying theproportions, any CWST between 35 to 45 to over 110 dynes per cm can beobtained. The devices so made are distinguished from devices preparedusing components treated with surfactants, in that surfactants areremoved by liquid passing through the device, whereas the alteration ofsurface characteristics obtained by grafting is permanent, and is notremoved or altered by any amount of liquid passing through the devicenor are the physical properties of the liquid altered, and in particularthe surface tension is not altered.

Liquids with surface tensions lower than the CWST of the porous mediumwill wet the medium and, if the medium has through pores, will flowthrough it readily. Liquids with surface tensions higher than the CWSTwill not flow at all at low differential pressures, but will do so ifthe pressure is raised sufficiently. If the surface tension of theliquid is only slightly above the CWST, the required pressure will besmall. Conversely, if the differential between the CWST and the surfacetension of the liquid is high, the pressure required to induce flow willbe higher.

It has been discovered that, when a liquid is forced under pressure topass through a fibrous mat which has a CWST 15 to 20 dynes/cm lower thanthe liquid's surface tension, flow tends to occur in a non-uniformfashion, such that some areas of the mat remain dry. This is highlyundesirable in a leukocyte depletion device, first because the pressuredrop is higher causing earlier clogging, second because all the flowpasses through only a portion of the available area, again increasingthe probability of clogging, and third because only a portion of thefiber surface area available for adsorption of or retention byfiltration of leukocytes is used for that purpose and, as a result,leukocyte removal is less efficient.

Solutions to the Problems of Poor Wetting of Synthetic Fibers andConsequent Slow Priming

Fiber surface characteristics can be modified by a number of methods,for example, by chemical reaction including wet or dry oxidation, bycoating the surface by depositing a polymer thereon, and by graftingreactions which are activated by exposure to an energy source such asheat, a Van der Graff generator, ultraviolet light, or to various otherforms of radiation, among which γ-radiation is particularly useful.

As examples of these various methods, stainless steel fibers can be madewater wettable, i.e., provided with a γ_(c) greater than 72 dynes/cm byoxidation in air at about 370° C. to produce a thin oxide surface skin.Synthetic organic and glass fibers may be coated by polymers whichcontain at or near one end a reactive (e.g., epoxide) moiety and at theother a hydrophilic group. While the above methods and others known tothose familiar with surface modification techniques can be used,radiation grafting, when carried out under appropriate conditions, hasthe advantage that considerable flexibility is available in the kinds ofsurfaces that can be modified, in the wide range of reactants availablefor modification, and in the systems available for activating therequired reaction. In the subject invention γ-radiation grafting hasbeen focused on because of the ability to prepare synthetic organicfibrous media with CWST over the full range of from 50 to well above 75dynes/cm. The products are very stable, have undetectably low aqueousextractables levels and, in addition, improved adhesion between fibersis obtained when used in preformed prefiltration or adsorption elements.

Alternative means for coping with the poor wetting characteristics ofsynthetic fibers include changing the surface tension of the plasma inwhich the red cells are suspended, or changing the surfacecharacteristics of the red cells. This can be accomplished, for example,by providing in the leukocyte depletion device a surfactant or a solublematerial which reduces the surface tension of the red cell suspension.

The gel prefilter element used in preparing test devices for examples1-106 was impregnated with a solution of a non-ionic surfactant whichinduced a surface tension of 48.5 to 51.5 dynes/cm in PRC flowingthrough it. Examples 107 et seq were performed using no surfactant.

Selection of Fiber Diameter for Use in Leukocyte Depletion Devices

As noted in the section headed "Characteristics Desirable in a LeukocyteDepletion Device", adsorption of leukocytes on fiber surfaces is widelyaccepted as the mechanism of leukocyte removal. Since the surface areaof a given weight of fibers is inversely proportional to the diameter ofthe fibers, and removal of leukocytes by adsorption to the fibersurfaces is a significant mechanism for leukocyte depletion, it is to beexpected that finer fibers will have higher capacity and that thequantity, as measured by weight of fibers necessary to achieve a desiredefficiency, will be less if the fibers used are smaller in diameter.

For this reason, the trend has been to use finer fibers for leukocytedepletion. Historically, as the technology required to produce smallerdiameter fibers has advanced, they have soon thereafter been packed intohousings and/or proposed to be used for leukocyte depletion.

Selection of Fiber Material for Use in Leukocyte Depletion Devices

A number of commonly used fibers, including polyester, polyamides, andacrylics, lend themselves to radiation grafting ,because they haveadequate resistance to degradation by γ-radiation at the levels requiredfor grafting, and they contain groups with which available monomers canreact during or after irradiation.

As noted above, fiber diameters should be as small as possible.Synthetic fibers made by conventional spinneret extrusion and drawingare not currently available smaller than about 6 micrometers indiameter.

Melt blowing, in which molten resin is attenuated into fibers by a highvelocity stream of gas and collected as a non-woven web, came intoproduction in the 1960's and 1970's and has been gradually extended overthe years with respect to the lower limit of fiber diameter with whichwebs could be made. Within recent years, webs with fiber diameters lessthan three micrometers have been achieved, and more recently, webs ofgood quality with average fiber diameter less than two micrometers havebeen made.

Some resins are better adapted to melt blowing of fine fibers than areothers. Resins which work well include polypropylene, polymethylpentene,Nylon 6, polyester PET (polyethylene terephthalate), and polyester PBT(polybutylene terephthalate). Others that have not yet been tested maybe found. Of the above listed resins, polyester PBT is a preferredmaterial because it also lends itself to radiation grafting and tosubsequent conversion into preformed elements of controlled pore size byhot pressing.

Polyester PBT has been the principal resin used for the development ofthe products of this invention and is, except for the gel prefilter, theresin used in the examples. It should be noted, however, that otherresins may be found which can be fiberized and collected as mats or webswith fibers as small as 1.5 micrometers in diameter or less, and thatsuch products, with their CWST adjusted if necessary to the optimumrange, may be well suited to the fabrication of equally efficient butstill smaller leukocyte depletion devices. Similarly, glass fibers,appropriately treated, may make possible devices with very low hold-upof blood.

The critical surface tension (γ_(c)) of PBT has been reported to be 45dynes/cm and its CWST in the form of a fine fibrous mat has beenmeasured as 52 dynes/cm.

Use of Needled Web in the Gel Prefilters

Non-woven webs are formed by a variety of means. The fibers may besuspended in air as they are extruded from molten plastic, and collectedfrom air suspension on a moving belt or drum while still in a softenedstate or after the fibers have hardened. In another system the fibersare extruded and drawn as continuous filaments, which are then cut ortorn to lengths of about 2 to 6 cm, followed by suspension in air andcollection on a moving belt or drum. The surface on which the fiberscollect is moving in the machine direction, generally at speeds of about10 to 1000 meters/minute; as a consequence of this linear motion, thefibers within the web tend to be oriented more or less parallel to eachother, and quite generally also parallel to the plane of the web; theymay thus be classified as "planar parallel".

"Needled" webs, also known as "needle punched" webs are made by furtherprocessing a planar-parallel web by passing it through a machine fittedwith a large number of rapidly reciprocating multiply barbed needles,which randomly engage fibers and pull or push them through the thicknessof the web, causing fibers from one face to be pulled to the oppositeface, where they become entangled with fibers at that face.

Multiple water jets have also been used to accomplish interlacing offibers throughout the thickness of the web and the product of these (andother methods if they exist or may be developed) will be referred tohereinafter as having been "needled".

Needled webs are lofty, as they are made with very low density (oftenranging in voids volume from about 95 to about 99%), and are relativelythick (often over about 3 to 5 millimeters). Their structure whenexamined by microscopy gives the appearance of an assembly of randomdiameter coils, many of which are oriented with the coil axis parallelto the plane of the web, and may be seen to offer easy access into theinternal portion of the web for blood gels, which tend to be globular inform. This structure is in strong contrast with the orientation of aplanar parallel non-woven web in which the fibers are parallel to theplane of the web, and which tend, even when quite coarse, to retainglobular gels at or near the surface of the web.

Thus, blood gels appear to be readily able to enter into the very opensurface of the coils of a needled non-woven while entry into a non-wovenwith fibers oriented parallel to the web is more difficult. It furtherappears that once gels have entered a needled web, they tend to beefficiently retained by smaller pores, which may be readily seenmicroscopically to be present. In effect, the curly fibrous structureallows easy entry and good retention, while structures comprisingrelatively straight fibers do not provide easy entry, and hence clograpidly as gels collect at their upstream surface.

As gel laden blood flows through a needled filter medium, smaller poresare randomly encountered, and these are sufficient in number to have thenet effect of collecting all or nearly all of the gels within themedium. This occurs with a very small increase in pressure drop, sincethe larger pores remain open to provide free passage for flow of the redcells suspended in plasma.

Whether or not these concepts of the filtration mechanism are valid, ithas been found experimentally that the needled non-wovens are peculiarly(and unexpectedly) effective in allowing entry of gels and in thenretaining them, while permitting blood or PRC to flow through them witha very small or negligible pressure drop increase.

In the course of the development of this invention, and prior to thefirst use of needled web in the examples of this invention, hundreds oftests were run with the objective of achieving consistently passage oftwo units of PRC with blood hold-up volume comparable with that of theexamples. These tests used as many as 15 or more separate layers ofmedium, with stepped pore sizes varying in 7 to 10 steps from over 50micrometers down to 5 to 10 micrometers. These tests used planarparallel non-woven media, and none were successful.

The use of needled webs made possible the development of the filters ofthis invention, which are capable of consistently processing older bloodwith high efficiency, without clogging and a hold-up volume of less than30 to 35 cc.

While means other than needling may exist, or may be developed in thefuture, which produce media which on microscopic examination are similarto the needled media used in this invention, it should by understoodthat products made using such media fall within the scope of thisinvention.

A wide range of fibers, fiber combinations, and/or binders can be usedto form the punched web. Any of these may be used if (a) they areamenable to subsequent controlled compaction by hot compression or byother means and (b) they are made using materials and under conditionsappropriate for use in a device for processing human blood.

The webs used in the gel prefilters in the examples of this inventionwere formed using needle punched fibers with a non-ioniclubricant-finish (Freudenberg Non-Woven Ltd. Partners grade P14 ofnominal weight 80 grams per square meter), in consequence of which asurface tension of 48 dynes/cm was measured when a 32 cm² disc wasimmersed into 300 ml of demineralized water. When gel prefiltersprepared from such fibers were used to process PRC, the surface tensionof the plasma of the PRC effluent from the device was reduced from about73 dynes/cm to 48.5 to 51.5 dynes/cm. Similar surface tension data wereobtained with other surfactants including ICI's Tween 80, BASF -Wyandotte's Pluronic L101 and Pluronic F68, all of which arephysiologically acceptable for use in parenterals. Prior to use inexamples 107 et seq the surfactant present in the needle punched mediumwas removed by detergent washing and water rinsing.

The Microaggregate Element

The principal function of the element following the gel prefilter isremoval of microaggregates. A subsidiary function is removal byadsorption of a portion of the leukocytes.

For these purposes it preferably combines two, three or more layers ofmelt blown web. The layers constituting this element can be preformedseparately and located adjacent to each other, or they can be preformedto a single element, or they can be combined with the adsorption elementto form a single integral element.

The Adsorption Element

The principal function of this element is to provide the largest portionof the fiber surface on which leukocytes are removed by adsorption. Itis most conveniently fabricated by preforming a number of layers ofrelatively smaller diameter fibrous web to form an integral element, oras noted above, it may be combined with the microaggregate element toform a single integral element comprising the adsorption element and themicroaggregate element.

Filter Adsorber Assembly

A "filter-adsorber assembly" is obtained when a gel prefilter isassembled in the correct order with a microaggregate element and anadsorption element. All of the components may be separately preformed,or they may be formed to integral subassemblies in any convenientcombination.

Description of an Exemplary Depletion Device

As shown in FIGS. 1-4, an exemplary depletion device 10 generallycomprises a housing 11 and a filter-adsorber assembly 12. The housing 11has an inlet 13 and an outlet 14 and defines a fluid flowpath betweenthe inlet 13 and the outlet 14. The filter-adsorber assembly 12 isdisposed within the housing 11 across the fluid flowpath and serves toseparate undesirable substances, such as gels, fat globules, aggregates,and leukocytes, from a fluid, such as a suspension of packed red cells,flowing through the housing 11.

Two sizes of depletion devices have been tested, differing only withrespect to the area through which the packed red cell suspension ispassed. The smaller, defined as the pediatric size, has an effectivearea of 32 cm², and the larger, defined as the adult size, has aneffective area of 62 cm². In both, disc-shaped filter-adsorberassemblies 12 are accommodated in cylindrical housings.

Housings can be designed to accept a variety of shapes offilter-adsorber assemblies. One such is, for example, a square. Thoseand other possible forms would in principle all be functional, providedthat adequate flow area is provided.

A square filter-adsorber assembly would in theory allow more economicaluse of material, but would be less reliable if an interference fit sealis used in the manner described below for housings fitted with discshaped filter-adsorber assemblies. If sealing is obtained by edgecompression about the periphery, significant effective area is lost atthe seal. For those reasons, cylindrical housings with disc shapedfilter-adsorber assemblies assembled with an interference fit seal arepreferred, although other forms may be used. Circular housings with aneffective cross sectional area of 32 and 62 cm² have been used indeveloping this invention.

Housings can be fabricated from any suitably impervious material,including an impervious thermoplastic material. For example, the housingmay preferably be fabricated from a transparent or translucent polymer,such as an acrylic or polycarbonate resin, by injection molding. Notonly is such a housing easily and economically fabricated, but it alsoallows observation of the passage of the fluid through the housing. Thehousings are designed to withstand normal abuse during service, as wellas internal pressures up to about 3 psi (0.2 kg/cm²). This permits lightconstruction, which is a desirable feature of this invention madepossible by the use of preformed filter-adsorber assemblies. The forcerequired to compress the fibers of an efficiently designedfilter-adsorber assembly by packing of fibers into a housing is as highas 68 kilograms for a 62 cm² disc, or about 1.1 kg/cm², requiringheavier, bulkier, and more costly housing construction.

While the housing may be fashioned in a variety of configurations, thehousing 11 of the exemplary separation device 10 is preferably fashionedin two sections, i.e., an inlet section 15 and an outlet section 16. Theinlet section 15 includes a circular inlet plate 20, and the insidesurface of the circular inlet plate 20 defines a wall 21 which faces theupstream surface of the filter-adsorber assembly 12.

The inlet 13 delivers the fluid to an inlet plenum 22 between the wall21 and the upstream surface of the filter-adsorber assembly 12. Inaccordance with one aspect of the invention, the inlet 13 delivers thefluid to the inlet plenum 22 at or near the bottom of the housing 11, asshown in FIGS. 1 and 2.

The inlet may be variously configured. However, the inlet 13 of theexemplary separation device 10 includes a longitudinal inlet ridge 23.The inlet ridge 23 extends along the outside surface of the circularinlet plate 20 parallel to a diametrical axis A of the housing 11,which, in use, is positioned with the diametrical axis A orientedgenerally vertically. The upper end of the inlet ridge 23 may befashioned as a socket for receiving a hollow spike 24 which is used topierce the bottom of a bag containing the fluid, e.g., a blood bag. Theinlet 13 further includes an inlet passageway 25 which opens at theupper end of the hollow spike 24, extends through the hollow spike 24and the inlet ridge 23, and communicates with the inlet plenum 22 at thebottom of the inlet section 15.

The wall 21 of the circular inlet plate 20 includes a plurality ofgenerally concentric circular ridges 26 which define concentric circulargrooves 27. The ridges 26 abut the upstream surface of thefilter-adsorber assembly 12. As shown in FIG. 2, the ridges 26 terminatein the lower portion of the inlet section 15, defining a passageway oraccess 30. The access 30 extends between the inlet passageway 25 andeach circular groove 27, allowing fluid to flow from the inletpassageway 25 to the circular grooves 27. Collectively, the circulargrooves 27 and the access 30 define the inlet plenum 22, whichdistributes the fluid delivered by the inlet passageway 25 over thewhole upstream surface of the filter-adsorber assembly 12. To preventaggregates and other large obstructions from blocking flow at or nearthe junction of the inlet passageway 25 and the inlet plenum 22 and, atthe same time, to minimize hold-up volume in the housing 11, the depthof the inlet plenum 22 is greatest at the bottom of the housing 11 anddecreases along the vertical axis A to a minimum value at the horizontalcenterline of the housing 11.

The outlet section 16 of the housing 11 includes a circular outlet plate31 and a cylindrical collar 32 which extends from the periphery of thecircular outlet plate 31 to the periphery of the circular inlet plate20. The cylindrical collar 32 is preferably integrally formed with thecircular outlet plate 31 and joined to the circular inlet plate 20 inany suitable manner, e.g., by an adhesive or by sonic welding.

The inside surface of the circular outlet plate 31 defines a wall 33which faces the downstream surface of the filter-adsorber assembly 12.The wall 33 includes a plurality of generally concentric circular ridges34 which define concentric circular grooves 35. The ridges 34 abut thedownstream surface of the filter-adsorber assembly 12. The circulargrooves 35 collectively define an outlet plenum 36 which collects thefluid passing through the filter-adsorber assembly 12. The depth of theoutlet plenum 36 is made as small as possible to minimize hold-up volumewithin the housing 11 without unduly restricting fluid flow.

In accordance with another aspect of the invention, the wall 33 furtherincludes a passageway such as a slot 40 which communicates with theoutlet 14 at or near the top of the outlet section 16. The slot 40,which collects fluid from each of the circular grooves 35 and channelsthe fluid to the outlet 14, preferably extends from the bottom to thetop of the outlet section 16 along the vertical axis A. In the exemplaryseparation device 10, the width of the slot 40 remains constant but thedepth of the slot 40, which is greater than the depth of the outletplenum 36, increases from the bottom to the top of the outlet section 16along the vertical axis A. Alternatively, the height may be less thanthe diameter of the housing, the width may vary, or the depth may remainconstant. For example, the slot may extend from the top of the housingalong the vertical axis A a distance in the range from about 80% of theinside diameter of the housing.

The outlet 14 may be variously configured. However, the outlet 14 of theexemplary depletion device 10 includes a longitudinal outlet ridge 41which extends along the outside surface of the outlet plate 31 parallelto the vertical axis A. The lower end of the outlet ridge 41 may befashioned as a tubing connector or as a socket for receiving a tubingconnector or other apparatus. The outlet 14 further includes an outletpassageway 42 which communicates with the slot 40 at or near the top ofthe housing 11, extends through the outlet ridge 41, and opens at thelower end of the outlet ridge 41.

As blood starts to flow through the apparatus, filling it from thebottom and emptying at the top, air is displaced and flows towards andout of outlet passageway 42. By careful design of the exemplaryapparatus it has been possible to reduce, but not to eliminatecompletely, the situation in which some liquid reaches the area 43adjacent to the outlet passageway 42 before all of the air is clearedfrom the inner parts of the housing assembly. In the absence of slot 40,this lagging air flow would carry some red cell-containing suspensioninto the outlet . tube 42. Slot 40 allows the blood so carried to flowinto the slot, where the air is harmlessly separated from the liquidsuspension. The air then rises harmlessly to the outlet 14 ahead of therising fluid level in the slot 40 and is almost completely ejectedbefore the liquid level reaches the top of the outlet plenum 36 andoutlet passageway 42. Thus, air is very efficiently cleared from thehousing 11 of the exemplary depletion device 10 according to theinvention. For example, in a depletion device which has an insidediameter of 8.9 centimeters, an initial air volume of 36 cc, and a slot8 centimeters high, 0.73 centimeters wide, 0.2 centimeters deep at thebottom, and 0.33 centimeters deep at the top, the residual volume of airpassing through the outlet after 1 or 2 cc of blood has passed throughthe outlet is estimated to be less than 0.1 cc.

In order to understand the importance of the slot and the flow passageconfiguration, the equivalent operation of a conventional leukocytedepletion unit will be described.

In conventional units, fluid enters at the top of the housing and exitsat the bottom. The housing of such a unit is typically connected byplastic tubing between a blood bag upstream from the conventionalhousing and a transparent drip chamber downstream from the conventionalhousing and thence to the patient. During priming, the housing alongwith the drip chamber is inverted and blood is forced through theconventional housing into the drip chamber. This has the disadvantagethat some pressure head is lost, but, more seriously, fluid reaches theexit of the conventional housing and enters the drip chamber while asmuch as 1 to 2 cc or more of air is still trapped in the conventionalhousing. When 3 to 4 cc of fluid has been collected in the drip chamber,it and the housing are returned to their normal position, leaving areservoir of fluid in the bottom of the drip chamber and an air spaceabove the fluid reservoir.

The transparent drip chamber performs a service in permittingobservation of the droplet rate through the air space, thus providingguidance for flow regulation. It also performs a second service in thatlagging air entering from the conventional housing is prevented fromreaching the patient. Instead, the lagging air displaces an equivalentvolume of fluid in the reservoir of the drip chamber. However, thereservoir must be large enough to ensure that the lagging air nevertotally displaces the fluid. Otherwise, the air may enter the vein ofthe patient.

Systems which permit a significant volume of air, e.g., 1 to 2 cc, toreach the drip chamber after it has been returned to its normalposition, tend to do so non-reproducibly. Thus, the larger the volume oflagging air, the larger the volume of fluid which must be collected inthe reservoir of the drip chamber. At the end of the administration,much of that volume is left in the drip chamber and, hence, is wasted.Because many of the fluids administered to a patient, e.g., fluidscontaining blood components such as red cells, are often difficult toobtain and exceedingly expensive, wasted fluid can be very costly. Bymaximizing air clearance and thereby allowing the use of a smallerreservoir in the drip chamber, the depletion device according to thepresent invention significantly reduces the amount of fluid wastedduring administration.

The filter-adsorber assembly 12 preferably comprises a number ofindividually preformed layers as described below under the headingFabrication of Fibrous Elements. During the development stage, housingswere constructed for testing which incorporated the basic internalconfiguration described above, but in addition were variable withrespect to the thickness of the filter-adsorber assembly. In this way,it was possible to test filter-adsorber assemblies varying in totalthickness. In each case, the distance between the tips of the ridges 26,34 of the inlet and outlet sections was adjusted to be equal to thenominal total thickness of the filter-adsorber assembly.

To provide an interference fit of the filter-adsorber assembly 12 withinthe housing 11, the filter-adsorber elements were cut from largeprecompressed slabs to a diameter 0.1 to 1% larger than the insidediameter of the cylindrical collar 32. The filter-adsorber elements werecut in such a manner as to maintain true right cylindrical form at theirouter edges. This, coupled with the slight oversizing, provides goodedge sealing, i.e., an interference fit, between the outer edges of thefilter-adsorber assembly 12, made up of the various filter-adsorberelements, and the inner periphery of the housing 11, with 100%utilization of the full area and volume of the filter-adsorber assembly12, thereby minimizing hold-up volume.

The edge sealing obtained by the interference fit has been shown on itsown to be adequate, however, the importance of providing highreliability in production units is such that an auxiliary seal may beconsidered desirable. Such a seal can comprise a pair of inwardly facingflanges 1 to 1.5 millimeters wide, dimensioned such as to compress thefilter medium between these peripheral flanges by 20 to 60%. Assemblieswith and without this auxiliary seal have been used in the developmentof this invention.

Fabrication of Fibrous Elements

The fibrous elements which are assembled into the above describedhousings comprise a number of discrete individual elements, each ofwhich performs one or more functions. In a preferred configuration ofthe leukocyte depletion device of this invention, and in the order inwhich the fluid flows, these layers comprise:

1. A first element is referred to as the gel prefilter. A highproportion of whole blood and PRC specimens contain gels, which veryeffectively clog filter media. These gels form a phase distinct from,and not miscible with, the blood plasma in which they are suspended, andvisually are seen to have higher viscosity. The state-of-the-artprocedure for coping with clogging of filters is enlargement of thepores of the upstream face of the filter, followed by successivelyvarying smaller pores, continuously or in steps, but this procedure forreasons not fully understood was ineffective when applied prior to thedevelopment of the gel prefilter of this invention.

We have discovered that a very effective gel removal filter can be madeby using as a starting material non-woven web made by the needlepunching process, with average fiber diameter between 10 to 40micrometers, preferably between 15 and 30 micrometers, and morepreferably between 20 and 25 micrometers. Needled webs are made using anumber of multiple barbed needles, with the barbs oriented both upwardand downward, which cause the fibers to assume the form of irregularloops, circles, and spirals, interspersed with a variety of otherirregular shapes. In general, a majority of the fibers have the form ofirregular shapes, with very few straight sections. Gels appear topenetrate easily into this type of web, and to be effectively retainedwithin the web, as may be seen by post-test microscopic examination.

Needled webs with these characteristics are generally made thicker thandesired for gel removal, and for optimal results must be compressed to acontrolled smaller thickness. Fabric so made was discovered to be notonly particularly effective in retaining gels, but to do so whileoccupying relatively little space within the filter housing. The smallerhousing achieved in this manner holds up less blood, reducing PRC lossby about 50% compared with filters fitted with conventionalprefiltration.

While the gel prefilter does not recover microaggregates directly byfiltration, the gels it retains frequently contain a substantial numberof microaggregates in a wide range of sizes, and these are efficientlyretained along with the gels.

The gel prefilter is made with low density in order to have very highvoids volume, and when made with fibers smaller than 30 to 50micrometers in diameter, it is easily compressible. Webs made usingfibers much less than 10 to 20 micrometers may tend to be excessivelycompressible, to the point where a few inches of pressure head duringblood flow could cause a web partially filled with gels to becompressed, thereby reducing its pore diameter to an inefficient range.If made with fibers much above 30 to 50 micrometers, performance for gelremoval deteriorates because the open area at equal pore size is smallercompared with webs made using finer fibers.

Preferred materials for making the gel prefilters are polyethyleneterephthalate (PET) and polybutylene terephthalate (PBT). The PET webhas been used in the form of 23 micrometer average fiber diameter web ata weight of 7 to 9 mg/cm², while the latter (PBT web) was a melt blownweb with a filter diameter of 20 micrometers and with a weight/cm² ofabout 8 mg.

As purchased the PET medium has had too low a density, and the porediameter was larger than desired. In order to remedy this, the webs werehot compressed to smaller thickness. As the webs are very compressible,control of thickness was established using a means of measurementdenoted as the "fall-out test", as follows:

A 6.41 cm diameter disc is held in the jaws of a vernier caliper, withthe jaws oriented vertically downward. The jaws are then slowly opened.The vernier setting at which the disc falls is the "fall-out" thicknessof the disc.

For examples 1-106, a single layer of PET medium was used with thesurfactant-lubricant on the fiber retained. This was hot compressedusing the fall-out test to a value of 0.18 to 0.22 cm. A clearance of0.9 mm was allotted at assembly into the filter housing. Examples107-168 were similar except that the surfactant had been removed priorto hot compression.

Examples 169 et seq were made using:

(a) Upstream, one layer of PET hot compressed to a nominal fall-outvalue of 0.075 cm.

(b) Downstream, in the order noted, one layer of PET together with alayer of PBT medium, the two hot compressed together to form an integrallayer with a nominal fall-out value of 0.10 cm.

(c) At assembly into the filter housing the space allotted to theassembly of (a) and (b) was 0.15 cm.

2. The second element is the microaggregate removal element, whosefunction is to remove aggregates which form particularly in older PRC.

Preferred material for making this element is melt blown PBT web.

For use except as noted in examples 1-168, this element comprised thefollowing, listed in the order of flow:

A preformed layer made using three layers of web of average fiberdiameter respectively 15, 10 and 7 micrometers.

A single preformed layer of 4.5 micrometer average fiber diameter web.

A single preformed layer of 4.5 micrometer average fiber diameter web ofdensity in excess of the preceding layer.

As used in examples 169 et seq, the microaggregate removal elementscomprised the following, listed in order of flow:

A first, second, and third layer respectively of average fiber diameter3.5, 3.0 and 2.6 micrometers, hot compressed at assembly with theadsorption element described below, to make an integral element. Densityafter compression is lower compared with examples 1-168.

3. The third (adsorption) element has as its primary function theremoval of leukocytes, primarily by adsorption and secondarily byfiltration.

For examples 1-168, this element was prepared using multiple layers of2.6 or 4.5 micrometer fiber, integrally bonded by hot compression. Forexamples 169 et seq this element was made using four layers of 2.4micrometer fibrous web bonded together with the microaggregate removallayers to form an integral assembly of the seven layers.

The values cited above and in the examples can be varied within limitswhile meeting the objective of this invention. To determine whether anyparticular variation produces a fully equivalent product, tests arerequired. Thus, it should be understood that, while the precise fiberdiameters, weights, densities, thicknesses and number of layers can bevaried somewhat while achieving equivalent or possibly even betterresults, that which is disclosed herein is intended as a guide to thedesign of a device meeting the stated objectives of this invention andthat devices made with such variations fall within the scope of thisinvention.

With the exception of the gel prefilter, all of the elements arepreferably surface treated to a CWST in excess of about 55 dynes/cm, butnot in excess of 75 to 80 dynes/cm.

Grafting Improves Adhesion During Hot Compression

Hot compressed element preforms made using melt blown fibrous mats whichhave been surface modified to raise their CWST values by 5 or moredynes/cm are palpably better with respect to firmness and resistance tofraying when compared with discs made by hot compression followed byradiation grafting. Grafting prior to hot compression is for this reasonpreferred; however, serviceable elements could be made by hotcompression followed by grafting.

While the examples of this invention have used hot compression to formthe integral elements which together combine to provide prefiltration,gel removal, and adsorption, it would be feasible to form the integralelements by other means, such as resin bonding, and a device utilizingthis or similar alternatives is within the scope of this invention.

Melt blown fibers have been preferred for use in all but the first layerof these devices. Should finer melt blown or other fine fibers, forexample, fibers made by mechanical fibrillation of larger diameterfibers, become available in the future, their use in elements forleukocyte depletion devices would be within the scope of this invention.

Edge Sealing the Preformed Elements into the Housing

The housing is preferred to be of generally disc form, or morerigorously stated, in part have the form of a right cylindrical element.The preformed elements are made also in right cylindrical form, ofdimension 0.1 to 1% larger than that of the inner surface of thehousing. When assembled, a good seal is obtained, with no detectablebypassing during service.

CWST of the Elements

The gel prefilter (first) element may have a low CWST without harm, and,indeed, may function better in that condition. The results of tests inwhich sufficient PRC is run through a device to cause clogging or nearclogging, followed by dissection, inspection, and testing of thepressure drops of the individual layers, indicate that little, if any,improvement can be accomplished by increasing the CWST of this layer.The microaggregate filter and the adsorption section are preferablymodified to a CWST of between 55 to 80 dynes/cm, and more preferably tobetween 59 and 73 dynes/cm, and still more preferably to between 62 and68 dynes/cm.

Red Cell Recovery

No significant changes in hematocrit were detected when the hematocritvalues for the PRC in the bag were compared with the effluent from thedevices in accordance with this invention.

Some of the incoming blood or PRC is lost due to hold-up within thedepletion device. That loss is reported as hold-up volume.

Characterization of Porous Media by Physical Characteristics

Formulae have been proposed to predict pore diameter. These formulaetypically use fiber diameter, bulk (apparent) density; and fiberdensity. One such, for example, calculates the average distance betweenfibers. However, the average distance between fibers cannot be ameaningful predictor of performance as in any liquid flow path it is thelargest pore or pores encountered which control performances, and thisis particularly true of deformable "particles" such as leukocytes. In afibrous mat such as made by melt blowing, the fibers are parallel to theplane of the surface, but are otherwise laid down in a random manner,and the pore size distribution is quite wide. Other means for formingfibrous mats, e.g., air laying, or formation on a Fourdrinier screen,also produce wide pore size distributions. In these circumstances, theaverage distance between fibers is clearly a poor predictor ofperformance. A variety of other formulae have been proposed to allowcalculation of pore diameters from data on fiber diameter, fiber densityand bulk density, but in over forty years of devising means to make andapply filter media, this applicant has never found any formula usefulfor calculating a priori the effective pore diameter of filters forliquid service.

Measurement of fiber surface area, for example by gasadsorption--popularly referred to as "BET" measurement-- is a usefultechnique, as the surface area is a direct indication of the extent offiber surface available to remove leukocytes by adsorption. The surfacearea of melt blown PBT webs can be used to calculate average fiberdiameter: ##EQU1## where L=total length of fiber per gram, d=averagefiber diameter in centimeters, and A_(f) =fiber surface area in cm² /g.

If the units of d are micrometers, the units of A_(f) become M² /g(square meters/gram) which will be used hereinafter.

A second characteristic necessary to describe a porous medium adequatelyto permit it to be reproduced is its pore diameter (Dp). We have used amodified OSU-F2 test for this purpose; this test and its mode of use aredescribed in the following section, under the heading Examples.

Other characteristics which describe a porous medium include apparent(bulk) density (ρ) in grams/cubic centimeter (g/cc), the fiber density(also in g/cc), the thickness (t) of the elements of the medium,specified in centimeters (cm), the cross sectional area available forflow through the filtering element (A_(c)) in square centimeters (cm²)[32 or 62 cm² for all the examples], and the CWST in dynes/cm.Specifying these parameters defines a filter of filter-adsorber elementof predictable behavior when used for leukocyte depletion:

(a) A_(f), the fiber surface area per gram, when multiplied by theweight (A_(c) ×t×ρ) of the filter, is the fiber surface area availablewithin the filter for removal of leukocytes by adsorption.

(b) An objective of this invention is a filter which will pass two unitsof PRC without clogging. Insofar as the cross sectional area A_(c) isincreased, the rate of flow per unit area is decreased, hence there isless tendency for clogging.

(c) Dp and t define the efficiency with which leukocytes are removed byfiltration.

A fibrous filter-adsorber element for leukocyte depletion is defined byspecifying the density of the fibers from which it is made, as well asA_(c), A_(f), Dp, ρ, t, and its CWST for each component or sub-assemblyof components.

We have discovered that, in a fibrous leukocyte depletion filter,removal of leukocytes is accomplished partly by adsorption and partly byfiltration. An important aspect of this invention is that by carefullydefining and controlling Dp, and providing prefiltration in a novel butwell defined manner, a filter can be achieved which has substantiallylower volume when compared with a filter principally dependent onadsorption. This reduces the volume of PRC or blood hold-up, withimportant economy of PRC use, while at the same time providing higherefficiency and better capacity compared with the best similar deviceshitherto available.

Whereas previously available devices depended nearly completely orlargely on adsorption, and were relatively larger, the devices of thisinvention, using Dp as a basic design guide, depend comparativelysubstantially more on filtration, and as a result are smaller.

The following examples are offered by way of illustration.

EXAMPLES

The PRC and whole blood used in these examples were obtained from bloodbanks which conform to American Association of Blood Banks standards.Those using CPDA-1 anticoagulant were from the Greater N.Y. BloodProgram in Melville, N.Y., and red cells suspended in physiologicalfluid using the Adsol anti-coagulant system were obtained from theAmerican Red Cross Blood Services, Rochester Region in Rochester, N.Y.Unless otherwise noted, the tests of the examples were run with PRC.

No blood product, including PRC, could be obtained from the blood bankin less than 2 days after it was drawn, as this was the minimum periodrequired to test for the presence of infectious agents.

All leukocyte counts were made by conventional chamber counts, bywell-trained technicians, and data reported is the average of at leasttwo counts by different technicians. When testing adult size devices,two bags of PRC or of whole blood were used in serial fashion; theweight (or volume) of blood is reported as the total for the two, butthe leukocyte counts before and after processing are reported for eachbag separately. For pediatric size units, a single bag of PRC or wholeblood was used, and the leukocyte counts before and after are reportedseparately for the first half of the bag contents, and for a secondsample representing the second half of the bag.

Use of automatic counters for the leukocyte depleted filter effluentsprovides incorrect results, because automatic counters are designed tobe operated in the range of normal leukocyte content of whole blood andof normal PRC. Thus, the normal operating range of automatic counters is10 to 1000 times the levels reached in the examples herein; as aconsequence, automatic counter data at these low levels are notreliable. Counts were therefore done manually using normal chamber counttechnique.

Bag (i.e., influent) counts were determined using a Model ZM CoulterCounter. The conventional centrifugal method was used to determinehematocrits.

For the examples of this invention, priming times were determined whileapplying a pressure of about 0.2 kg/cm² to the bag of blood or PRC,either by hand, or with

a pressurizing cuff. A pressure of about 0.2 kg/cm² was determined bytest to be the range of pressure developed with manual compression ofthe blood bag by three randomly selected laboratory technicians.

Priming time is defined as the time required for filling the testhousing with fluid, and for the fluid to fill the inverted drip chamber2/3 full (approx. 3 ml).

For Examples 1-168, pressure head during the tests was adjusted asrequired to maintain flow of 4 cc/minute for the adult (62 cm²) deviceand 2 cc/minute for the pediatric (32 cm²) device. If during a test thepressure required to maintain the required 4 or 2 cc/minute flow reached100 cm of fluid pressure head, or about 0.1 kg/cm², it was held at thatpressure until flow fell to below respectively 1 or 0.5 cc/minute, atwhich time the test was terminated. Thus, if the final flow for an adultfilter is reported to have exceeded 1 cc/minute or 0.5 cc/minute for apediatric size unit, all of the blood had been withdrawn from the bag,and the device was not clogged. If the flow rate during a test fell toor below the limits noted above, the device was considered to haveclogged, and the residual weight in the bag is reported.

For examples 169-210, pressure head during the tests was adjusted asrequired to maintain flow of 6 cc/minute. If during a test the pressurerequired to maintain a 6 cc/minute flow rate reached 115 cm of fluidpressure head, or about 0.11 kg/cm², it was held at that pressure untilflow fell to below 1 cc/minute, at which time the test was terminated.If the volume of PRC left in the bag was less than 30 cc, the filter wasconsidered to have successfully passed that unit of PRC, as that wasdetermined by test to be the probable outcome during bedside service.

Minimal samples of approximately 5 ml were taken from each bag of bloodor PRC used for determination of influent characteristics. Where morethan one unit of blood or PRC was used, they were delivered sequentiallyand were individually sampled and assayed.

Leukocyte (WBC) counts are reported per microliter (1 microliter equals1 mm³) of fluid. Dilutions for counting varied from 1 count =100 WBC ofrelatively fresh blood to 1 count =50 WBC for tests using blood over 10to 14 days old.

The elements used in the examples were unless otherwise noted of discform, 64.1 mm diameter for use in the pediatric size device, and 88.9 mmdiameter at assembly for use in the adult size device. The stackedlayers of elements, with a total thickness of t_(e) were assembled intoa housing as described above, with a clearance of t_(h) between thefaces of the two plenums, i.e., between the tips of the ridges 26 on theinlet plate 20 and the tips of the ridges 34 on the outlet plate 31, asshown in FIG. 1. After piercing the blood bag, the filters were primedby manual pressure applied to the bag, or with a blood pressure cuffpressurized to approximately 0.2 kg/cm², after which whole blood orpacked red cells was passed by gravity and product assays made in themanner described in the preceding part of this section.

Losses of red cells due to adsorption were, unless noted, too small tobe detected. For the examples 169-210 losses due to hold-up can becalculated as =(47t_(h) +12)cc.

Pore diameters of filter media were determined using the modified OSU F2method and are reported as the diameter of hard particle at which 99.9%of the incident particles were removed. The F2 test used in making poresize measurements is a modified version of the F2 test developed in the1970's at Oklahoma State University (OSU). In the OSU test, a suspensionof an artificial contaminant in an appropriate test fluid is passedthrough the test filter while continuously sampling the fluid upstreamand downstream of the filter under test. The samples are analyzed byautomatic particle counters for their contents of five or morepreselected particle diameters and the ratio of the upstream todownstream count is automatically recorded. This ratio is known in thefilter industry as the beta ratio.

The beta ratio for each of the five or more diameters tested is plottedas the ordinate against particle diameter as the abscissa, usually on agraph in which the ordinate is a logarithmic scale and the abscissa is alog² scale. A smooth curve is then drawn between the points. The betaratio for any diameter within the range tested can then be read fromthis curve. Efficiency at a particular particle diameter is calculatedfrom the beta ratio by the formula:

    Efficiency, percent=100(1--1/beta)

As an example, if beta=1000, efficiency=99.9%.

Unless otherwise stated, the removal ratings cited in the examplespresented herein are the particle diameters at which beta=1,000, hence,the efficiency at the removal ratings cited is 99.9%.

In the modified F2 test, efficiencies in the range of from 1 to 20-25micrometers were determined using as a test contaminant an aqueoussuspension of AC fine test dust, a natural silicious dust supplied bythe AC Spark Plug Company. Prior to use, a suspension of the dust inwater was mixed until the dispersion was stable. Test flow rate was 44to 100 liters per minute per square foot of filter area, a range overwhich the results are unaffected.

The data applicable to examples 1-168 is presented as follows:

(a) Data pertinent to the manner of preparation and to the adsorptiveand filtration capabilities of the examples are presented in Table A.

(b) Behavior observed while processing blood products through thefilters is presented in Tables 1 through 16.

The data of Table A are presented as follows:

Column A lists the example numbers and the table numbers in which theblood data are presented.

Column B lists the sequence of the multiple individual filteringelements used in each test assembly. The upstream gel prefilter element(number one) in examples 1-168 unless noted comprises acrylic bondedneedle punched PET. The remaining elements are all made of melt blownPBT. The microaggregate removal element comprises layers 2a, 2b, 2c, 3and 4, with 2a, 2b and 2c hot compressed together to form a subassembly,and layers 3 and 4 hot compressed separately. Layer 5 is the adsorptionelement, formed as a single layer by hot compression.

Column C lists fiber surface areas in units of square meters per gram.Column D lists the element apparent (bulk) densities in units of gramsper cc. Column E lists element thickness, in centimeters. Column F liststhe fiber surface area in units of square meters for each of theelements (A_(t) =A_(f) ×ρ×t×62). Column G lists the fiber diameter Dpcalculated from BET measurement of surface area (fiberdiameter=(0.345A_(f))⁻¹ micrometers), except for the gel-prefilter whichwas estimated microscopically. Column H lists the pore size asdetermined by the modified OSU F2 test, in micrometers, also exceptingthe pore diameter of the gel-prefilter which was estimatedmicroscopically. Column I lists the CWST values for each layer.

Examples 1-18 were made as indicated in Table A. The CWST values listedare those of media of which the surfaces had not been altered.

Examples 19 to 34, presented in Table 2, were also run using fivelayers. Of these, the first was identical to that of Examples 1 to 18;the microaggregate filter was identical to that of Examples 1 to 18except that it was radiation grafted to a CWST of 59 dynes/cm. The fifthpreform was identical to that of Examples 1 to 18 except that it wasradiation grafted to a CWST of 65 dynes/cm.

Examples 35 to 38, presented in Table 3, made in the same way asExamples 19 to 34 except that the number 3 and 4 layers had beenradiation grafted to a CWST of 75, rather than 59, were tested usingwhole blood with CPDA-1 additive. Average efficiency for the second unitis substantially reduced compared with the results obtained in Examples19 to 34 (Efficiencies obtained with whole blood and with PRC may bemeaningfully compared because whole blood is a diluted form of PRC.).

Examples 39 to 42, presented in Table 4, were tested using packed redcells and illustrate the effect of increasing the CWST of the elementsof Examples 19 to 34. The microaggregate removal element had CWST of 81,while the adsorption element had a CWST of 75 dynes/cm. Compared withExamples 19 to 34, both capacity and efficiency are reduced.

Examples 43 and 44, presented in Table 5, further illustrate the effectof increasing the CWST of the microaggregate removal and adsorptionelements of the devices of Examples 19 to 34. Examples 43 and 44 areidentical to Examples 19 to 34, except that the CWST of the second layeris 81 dynes/cm, the third and fourth layers have CWST's of 77 dynes/cm,and the adsorption element has a CWST of 81 dynes/cm. The data show thatefficiency for the second unit of PRC is greatly reduced.

Examples 45 to 48, presented in Table 6, were run using theconfigurations of Examples 19 to 34, except that the fiber surfaces ofthe second, third, fourth, and fifth layers had been modified to a CWSTin excess of 94 dynes/cm. The data show that both efficiency andcapacity are reduced from those reported in Table 2 for Examples 19 to34.

Examples 1 to 18 of Table 1, Examples 19 to 34 of Table 2, Examples 35to 38 of Table 3, Examples 39 to 42 of Table 4, Examples 43 to 44 ofTable 5, and Examples 45 to 48 of Table 6, were all made using the samebasic construction, but with the CWST ranging from 52 (unmodified) togreater than 94 dynes/cm.

The results obtained vary from less than optimal at 52 dynes/cm, tooptimal at 59-65 dynes/cm, to somewhat less effective with respect toboth efficiency and capacity for CWST values in the range from 65-75 togreater than 95 dynes/cm. The Example group 19 to 34 represents apreferred configuration of this invention.

Nevertheless, it should be kept in mind that all of these examples aresuperior to all currently available devices for bedside administrationof red cells.

Examples 49 to 52, presented in Table 7, were prepared in the samemanner as the pediatric size examples of group 19 to 34 except asfollows: In Example 49, the gel prefilter element was omitted. InExample 50, the second layer was also omitted. In Example 51, the thirdlayer was omitted in addition to the previous two. In Example 52, onlythe adsorption element was used. As may be seen in Table 7, the volumepassed prior to clogging was decreased as each layer was removed, froman average of 308 ml to, respectively, 116, 46, 35, and 34 ml. Thesuperiority of the stepped pore prefiltration system of this inventionis thus clearly illustrated.

Examples 53 to 56, presented in Table 8, were part of a study todetermine the preferred thickness range of the gel prefilter element,the function of which is to remove gels and very large aggregates,together with smaller aggregates which are suspended in the gels. Theseexamples used a high loft, needle punched non-woven made usingapproximately 23 micrometer fibers, which had been hot precompressed toproportionally smaller thickness and then further compressed at assemblyto the thicknesses noted. The data of Table 8 may be compared withExamples 19 to 34, having been prepared in the same manner except withrespect to the thickness of the prefilter element. The data shows lossof capacity at thicknesses at and below 0.56 mm.

Examples 19 to 34 have a gel prefilter element thickness of 0.90 mm. Anumber of tests run at 0.65 and 1.14 mm have shown very nearly equalresults. Based on these data, the preferred range is in excess of about0.6 mm.

The upper end of the range has not been explored, beyond the test at1.14 mm. Based on post-test microscopic examination, we believe it to beprobable that considerably thicker first layers up to 2 to 3 mm could beused with good results. Such relatively large thicknesses are not,however, desirable, as they would result in increased hold-up. Forexample, in the adult size housing used in these tests (62 cm² ofeffective area), the addition of 1 mm in thickness increases hold-upvolume by 6.2 cc. Any increase is very undesirable.

Tests were run using the make-up of Examples 19 to 34 with the gelprefilter element made at the same density but using a starting weightof 11 mg/cm² and then compared post-test microscopically with the 8.8mg/cm² element. The 11 mg element, which is 25% thicker, was seen toprovide more space for gel collection than necessary, and based on this,the preferred weight using PET 23 micrometer fiber is 8.8 mg/cm². Lowerweights may be used, but with the risk of not providing the capacity topass two PRC units without clogging, which is an objective of thisinvention.

Fiber diameters other than 23 micrometers may be used for the gelprefilter, as long as the average pore diameter remains in the desiredrange. If fibers with average diameter differing from about 23micrometers are used, the weight W per unit area to provideapproximately equal pore diameter can be calculated with adequateaccuracy for fibers of diameter d by the formula: ##EQU2##

Means to accurately measure pore diameters in the range in which the gelprefilter is effective are not readily available. A satisfactory meansto verify that a given material which has been compressed to a thicknessof 0.9 mm has a pore diameter within the desired range of the gelprefilter in accordance with this invention employs the followingprocedure:

The material to be tested made to a weight of 8.8 mg/cm² is wetted byimmersing it in a solution of isopropyl alcohol followed by placing thematerial in a holder in which the test thickness is 0.075 cm and inwhich air pressure can be applied while monitoring air flow. In order tofunction within the parameters discussed above, the pressure developedat an air flow rate of 0.5 cms/second should fall within the range offrom about 3.5 to about 8.5 cm water column and preferably between about4 and about 6.5 cm water column.

Example 57 is directed to means by which the resistance to clogging ofdevices in accordance with this invention may be further increased. Thismay be accomplished by varying the pore size of the microaggregateremoval element continuously rather than stepwise.

Examples 58 to 65 were prepared as presented in Table A, and theirbehavior in processing PRC is presented in Table 9. The first fourlayers are identical with the first four of Examples 19 to 34. Theadsorption element consists of five layers of 4.5 micrometer PBT fibersradiation grafted to a CWST of 59 dynes/cm and then hot precompressed toform a single preform 0.251 cm thick having a density of 0.252 g/cc,and, in the adult size, a BET fiber surface area of 1.77 square meters,and an F2 pore size rating or average pore diameter of 6.9 micrometers.Total fiber surface area of the five layers was 4.07 square meters.Total volume of the five layers was 33.3 cc.

Examples 66 to 73, also presented in Table 9, were similar to Examples58 to 65 except that the third preformed layer was made using 4.5micrometer fibers compressed to a thickness of 0.069 cm and a density of0.18 g/cc, with an F2 pore diameter rating estimated to be 15micrometers, and the fourth layer was made using 4.5 micrometer fibersprecompressed to a thickness of 0.061 cm and a density of 0.21 g/cc,with an estimated F2 pore diameter rating of 12 micrometers. Theadsorption element, comprising five layers of 4.5 micrometer diameterweb radiation grafted to a CWST of 59 dynes/cm, was hot compressed to asingle 0.277 cm thick preform of density 0.229 g/cc and an F2 porediameter rating of 7.4 micrometers. The resulting data are shown inTable 9.

The data for Examples 58 to 65 and 66 to 73 are compared with those of19 to 34 and 96 to 97 in Table 10. The performance with respect toleukocyte removal efficiency of Examples 19 to 34 is clearly superior tothat of Examples 58 to 65, which in turn is superior to Examples 66 to73. This is surprising, because the surface area available for removingleukocytes by adsorption in the 58 to 65 group and the 66 to 73 group isidentical, i.e., both have 4.07 square meters of fiber surface area. Thesignificant difference between these two groups of examples is that thepore diameter of the number 5 element of Examples 58 to 65 (6.9micrometers) is smaller than that of Examples 66 to 73 (7.4micrometers). Smaller pore diameter, therefore, is seen to improveefficiency. This conclusion is confirmed when Example group 19 to 34 iscompared with Example group 58 to 65. The surface area of Example group19 to 34 is 3.29 square meters by BET surface area measurement, i.e., itis smaller than that of Example group 66 to 73 (4.07 square meters). YetExample group 19 to 34 has better efficiency. Again, the pore size ofthe downstream element of Example group 19 to 34 (6.1 micrometers) issmaller than that of Example group 66 to 73 (6.9 micrometers). Theconclusion can thus be drawn that the smaller pore size of theadsorption element of the 19 to 34 group is the factor which accountsfor its superior performance compared with elements of larger porediameters.

Examples 96 and 97, shown in both Tables 10 and 15, provide furtherevidence of the effect of pore size of the downstream element. As notedin Tables A and 10, and the descriptive paragraph devoted to Table 15,the structure of Example 96 and 97 differ from that of Examples 58-65only in that:

(a) The adsorption element contains less fiber, and the element assemblyhas a total surface area of 3.13 M².

(b) The average pore diameter of the adsorption element is 6.6micrometers.

Despite the substantially smaller fiber surface area available foradsorption and their smaller thickness (0.145 to 0.251 cm), Examples 96and 97 perform significantly better than Examples 58 to 65. Theimprovement can be due only to the smaller pore diameter of Examples 96and 97.

Examples 103-106, shown in Table 13, were prepared in the same manner asexamples 19 to 34 of Table 2, except that the adsorption element wascompressed to greater density and smaller Dp (pore diameter). Four testsof each density of this group were run using PRC derived from blooddrawn 2 to 4 days prior to the test. The tendency of this relativelyfresh PRC to cause clogging is less than with older blood, such as wasused at least in part for the tests reported elsewhere herein.

The data of Table 13 indicate that when used with fresh blood, poresizes as small as about 4 micrometers can be used, while achieving theobjective of passing two units of PRC prior to clogging.Parenthetically, all the tests in this series showed 100% removal ofleukocytes.

Thus, for use with PRC derived from blood drawn about four days or lessprior to its use in transfusion, a lower limit of 4 micrometers ispreferred, and a lower limit of 4.2 micrometers is more preferred.

Thus, pore diameter can strongly influence leukocyte removal efficiency.This was an unexpected discovery, as it is contrary to the belief thatleukocyte removal by fibrous media is a function only of surface area.As noted above, while granulocytes are larger than red cells,lymphocytes, which in normal whole blood account for 20 to 40% of all ofthe leukocytes, are comparable to the red cells in size.

By taking advantage of this discovery, it has been possible to reducethe blood hold-up volume by about 8% compared with Examples 58 to 65,and 16% compared with Examples 66 to 73. These are significantreductions, in effect reducing the cost of transfusing a single unit byabout $3 to $6 U.S. or more based on present hospital costs and bloodbank pricing.

Examples 74 to 78, presented in Table 11, were run at a flow rate of 4cc/minute of PRC in filter housings with 32 cm² of effective flow area,in this respect equal to the pediatric size of device, but with flowrate and total quantity of fibrous medium equivalent to that containedin the adult size units of Examples 19 to 34 (a preferredconfiguration). This was accomplished by use of eight layers, asfollows: The first and second layers were each identical with the firstlayer of group 19 to 34. The third layer was similar to the second layerof group 19 to 34, but used 15 mg/cm² each of 15, 10 and 7 micrometerfiber diameter medium which were laid up and hot formed to a disc 0.15cm thick. The fourth, fifth, sixth, and seventh layers were similar tolayers numbered 3 and 4 of Examples 19 to 34, except that they werecompressed respectively to preforms of density 0.18, 0.20, 0.22, and0.23 g/cc. The eighth and last layer was equal in fiber diameter anddensity to that of group 19 to 34 but twice the weight of fibers wascompressed to a preform of twice the thickness, i.e., to 0.304 cm. Thedata resulting from tests of these assemblies using PRC is shown inTable 11. Capacity is seen to be adequate albeit marginally so for freshblood, but is quite inadequate for blood aged more than a few days.Comparing these data with those of Examples 19 to 34, the advantages ofusing the same total quantity and type of each fibrous medium in adevice with larger cross section area become apparent.

Examples 79 to 85, presented in Table 12, show data obtained when "Adsolblood" was used. Except for this group of examples, all of the wholeblood and packed red cells used in the examples were run using CPDA-1processed blood. CPDA-1 is a combination of anti-coagulants andnutrients designed to increase the period during which the red cellsremain effective when transfused into a patient. In CPDA-1 whole bloodor CPDA-1 PRC, the red cells are suspended in plasma; due to the higherred cell concentration in PRC (hematocrit generally in the 70 to 80%range), its viscosity is quite high, and for this reason capacity forPRC tends to be less than capacity with whole blood, for which thehematocrit is lower, and viscosity is much lower.

Within the last several years, a new class of blood product has beendeveloped in which after centrifuging to concentrate the red cells tonear to 100%, they are resuspended in a saline solution containingpreservatives which extend the useful life of the red cells by about 7days compared with the CPDA-1 system. This class of blood product hasbeen defined as "products in which the red cells are suspended in aphysiological fluid medium". The Adsol system is one such systemcurrently seeing some use in the USA and may be considered asrepresentative of others in the USA, Europe, and Japan.

As this type of blood product contains only a very small proportion ofthe original plasma and the red cells have been resuspended in the lowviscosity physiological fluid, viscosities are even lower than those ofwhole blood. Examples 79 to 85 used the form of device employed inExamples 66 to 73, all run on the device sized for pediatric service.The data show faultless performance on Adsol blood, despite the factthat the devices of 79 to 85 and 66 to 73 are not the most preferredform of this invention.

Devices having the configurations of Examples 19 to 34, 58 to 65, 66 to73, and others were run using whole blood with CPDA-1 anti-coagulant.Behavior with respect to capacity and efficiency were generally similarto the data reported for the Adsol product.

Examples 86 to 95 are presented in Table 14. Example 90 was not actuallyperformed; the data entered are the averages of Examples 19 to 34.Examples 86 to 89 and 91 to 95 were performed, and are similar toexample 90 except that the adsorption element densities and thicknesseswere varied, while the weight was held constant. As may be seen in Table14, the pore diameter is a critical determinant of efficiency, which forthe first unit of PRC transitions from 87%, at a pore diameter of 7micrometers, to 99.2% at 6.2 micrometers, and to 100% at 6.1micrometers. Leukocyte removal efficiency for the second unit of PRCchanges in parallel fashion, from about 70% at 6.7 to 7 micrometers, to99.6% at 6.1 micrometers, and to 100% at 6.0 micrometers. From thesedata, it is seen that, for the adsorption element of a device made using25 mg/cm² of 2.6 micrometer diameter fibers, a preferred upper limit forpore diameter is about 6.7 micrometers, while a more preferred limit is6.3 micrometers.

Below about 6.1 micrometer pore diameter all of the examples in thisgroup showed essentially 100% leukocyte removal efficiency for two unitsof PRC, and while there are some instances of clogging, satisfactorydata are seen at as low as 5.5 micrometers. Hence a preferred range ofpore diameter is about 5.5 to 6.7 micrometers, while a more preferredrange is about 5.8 to 6.3 micrometers.

Examples 96 to 101 are presented in Table 15, and described in Table A.These examples were prepared in the same way as Examples 58 to 73,except that the downstream layer was made using three instead of fivelayers of 4.5 micrometer fibers hot precompressed to the thicknesses anddensities noted. Total surface area of the five elements in thepediatric size used was 1.51 M², which for purposes of comparison (ref.Table 10) calculates to 3.13 M² in the adult size. As may be seen inTable 15, removal efficiencies of 100% for both the first and secondunits are obtained at pore diameters below about 6.6 micrometers; thismay be compared in Table 10 with the onset of lower efficiency atdensity 0.255 g/cc and pore diameter 6.9 micrometers for Examples 58 to65, and with the still lower efficiency at density 0.229 g/cc and porediameter 7.4 micrometers of Examples 66 to 73. From these data, it maybe seen that a preferred value for the upper limit of pore diameter isabout 7.5 to 8 micrometers, and a more preferred value is 6.6micrometers. Below 6.6 micrometers efficiencies remain at 100%, butfrequency of clogging is seen to increase, in consequence of which apreferred lower limit is about 5 to 5.5 micrometers, and a morepreferred limit is 6 to 6.5 micrometers.

Taken together, Examples 19 to 34, 58 to 65, 66 to 73, 86 to 95, and 96to 101 indicate a preferred F2 pore diameter range of 5.0 to 8micrometers, and more preferred range of 6 to 6.7 micrometers. Theselimits of preference are discussed in more detail below.

The Preferred Limits of Pore Diameter

As the data of examples 1-107 were reviewed, a number of conclusionswere drawn in order to define the preferred range of pore diameter.

(a) Based on examples 102-106 of Table 13, tested using only fresh PRC,a low limit of 4 micrometers was preferred, with 4.2 micrometers morepreferred.

(b) Based on examples 86 to 95 of Table 14, an upper limit of 6.7micrometers was seen as preferred, with 6.3 micrometers more preferred.As a lower limit 5.5 micrometers was preferred, with 5.8 micrometersmore preferred.

(c) The data presented in Table 10 suggest a range no narrower than 6.1to 6.6 micrometers as most preferred; further, since the results forExamples 66-73 of Table 9 are far better than any product available asof this writing, a less preferred upper limit of 7.4 micrometers isjustified.

(d) Finally, a review of examples 19-34, 58-65, 66-73, 86-95 and 96-100taken together indicated a preferred range of 5 to 8 micrometers, and amore preferred range of 6 to 6.7 micrometers.

As to the low limit, since some physicians prefer to use only freshblood for patients such as those with disabilities such as thalassemia,a preferred low end pore diameter should be 4 micrometers.

Taken together with the other considerations listed above, a preferredrange is 4 to 8 micrometers. The lower part of this range is preferredfor use with recently drawn PRC, while the upper part is preferred foruse with older PRC.

The devices used in Examples 107 to 168 (see Table 16) were prepared inthe same manner as examples 19 to 34 except that the medium used to makethe gel prefilter had been scrubbed and rinsed and therefore containedno surfactant. Examples 107-119, were prepared with no surfacemodification, and had CWST of 52 dynes/cm. Examples 120 to 168 compriseelements which, except for the gel prefilter, were radiation-grafted(using mixtures of HEMA and MA and a minor amount of tertiary butylalcohol to assist wetting) to modify their CWST valves over the rangefrom 63 to 109 dynes/cm. Except for the absence of surfactant from thegel prefilter, and their varying CWST values, Examples 120 to 168 wereequal in construction to examples 19 to 34.

All of the examples 107 to 168 showed 100% removal of leukocytes for thefirst unit of PRC passed, and the average efficiency in each grouplisted in Table 16 for the second unit exceeded 96%.

It is seen in Table 16 that clogging prior to passage of two unitsoccurs with greater frequency when the CWST of the filter medium isbelow 75 dynes/cm. This may be related to the surface tension of thePRC, which, as noted above, has been reported to be 73 dynes/cm for theplasma and 64.5 dynes/cm for the red cells.

Based on the data of Table 16, a preferred value of the CWST of filtermedia is in excess of 63 dynes/cm; a more preferred value is in excessof 70 dynes/cm; and a still more preferred value is in excess of 75dynes/cm. It should, however, be noted that the data for all of theexamples are better than any product now on the market.

During the course of preparing examples 1-210, filter assemblies withCWST's of 54 dynes per cm were made and tested with satisfactoryresults; however, CWST values only two units different from untreatedPBT fiber are considered marginal with respect to maintaining consistentperformance, hence 54 dynes/cm is a less preferred value of the CWST.

The needled web used in examples 169 et seq was scrubbed prior to use toremove the fiber lubricant, rinsed with water, and then dried. The meltblown web used was unless otherwise noted radiation grafted to obtain aCWST of 64 dynes/cm.

Preform thickness was measured using a 7.7 cm diameter anvil and with anapplied pressure of 4.3 g/cm².

The filter assemblies used in examples 169-186, presented in Table 17,comprised three preforms.

For preform number one, the 23 micrometer needled non-woven webdescribed above was hot calendered to a thickness of 0.076 cm. Forpreform number two, a layer of 23 micrometer average fiber diameter0.0077 g/cm² needled non-woven web was laid over a 20 micrometer averagefiber diameter 0.0081 g/cm² ungrafted melt blown web, and the two hotcalendered in assembly to a thickness of 0.102 cm. The above twopreforms were combined in the order listed, prewetted with isopropylalcohol, and air passed at 0.5 cms/second; pressure drop for ten suchassemblies ranged from 5 to 7 cms of water column.

For preform number three, seven layers of melt blown web were used. Inorder, these were: one layer of 3.5 micrometer diameter fiber at 0.0069g/cm² ; one layer of 3.0 micrometer diameter fiber at 0.0052/cm² ; onelayer of 2.6 micrometer diameter fiber at 0.0063 g/cm² ; and four layersof 2.4 micrometer fiber diameter at 0.0061 g/cm² per layer, all sevenlayers calendered in assembly to a thickness of 0.296 cm, for an averagedensity of 0.145 g/cc.

In the above construction, the first and second preforms togetherconstitute a first element, denoted the gel prefilter element. The firstthree layers of the third preform constitute the microaggregate removalelement, although this element also contributes to removal of leukocytesby adsorption. The last four layers of the third preform constitute theadsorption element.

In order to make it possible to determine the pore diameters of thethree layers which constitute the microaggregate element, and the porediameter of the adsorption element, each of the three microaggregatelayers was underlaid prior to hot compression by a layer of an openpored ungrafted separation disc. The 0.004 cm thick separation discs hadan average pore diameter greater than about 100 micrometers, hence hadno significant effect on performance of the assembly, other than athickness increase of 3×0.004=0.012 cm. Filter assemblies so preparedwere used in all of the examples 169-210. By this means, the layers werereadily separated in order to determine their pore diameters by OSU-F2testing. Layers number 1, 2 and 3 of the third preform had porediameters respectively of about 19, 16 and 13 micrometers, and theremaining group of four layers varied in pore diameter from 6.5 to 8.2micrometers among six sample groups. The three preforms when assembledhad a total thickness t_(e) of 0.474 cm, and these were assembled into ahousing with ridge to ridge clearance t_(h) of 0.444 cm, therebycompressing the element assembly to 0.444 cm.

Examples 169-174 presented in Table 17 were performed using PRC 24 daysold. All six tests successfully met the criterion noted above (i.e.,less than 30 cc residual with pressure head of 115 cm of water and flowrate <1 cc/minute).

Examples 175-180 were performed with PRC of average age 34.5 days; fiveof the six tests met the completion criterion.

Examples 181-186, run with two day old PRC, met the completioncriterion, and more important, show 100% efficiency of leukocyte removalfor the first unit, and an average efficiency of 98.8% for the secondunit.

Examples 1-168 describe devices for use in removing leukocytes from PRC,but these examples are directed primarily to use with relatively fresh(recently drawn) PRC, and are better suited for applications in whichfresh PRC is used. Of more than 100 units of PRC listed as used inexamples 1-168, only six more than 20 days old were used with filters ofthe type which are the subject of this invention. Of the six, two whichused 29 and 30 day old PRC clogged prior to completing delivery of twounits.

In U.S. hospital practice, PRC anti-coagulated with CPDA-1 is permittedto be used after storage for up to 35 days. Persons knowledgeable ofU.S. hospital practice were questioned on the proportion of CPDA-1 PRCused which is more than 15-20 days of age; the mean of their estimateswas 40%. The same authorities estimated that about 80% of alltransfusions use two units of PRC while the remainder use only one. Itis less practical for most hospitals to carry two kinds of leukocytedepletion devices, one for fresher and the other for older PRC. Thus, tobe more practically useful, a device intended for use in hospitalbedside service should experience at most a very small proportion ofinstances in which the device clogs prior to delivery of two full unitsof blood, even if those units are near or at the outdate limit beyondwhich they may not be used for transfusions. The same device must havehigh removal efficiency with PRC of all ages, preferably over 99.5% to99.9% for the first unit passed, and over 95 to 99% for the second unitpassed.

The test articles used for examples 1-168 are similar to the testarticles of examples 169-210 in that needled non-woven of the same fiberdiameter and weight is used to fabricate the gel prefilter, and the meltblown components are generally similar with respect to pore size rangeand CWST, but differ with respect to the mode of use of thesecomponents.

The gel prefilter of examples 1-168 uses a single layer of needlednon-woven, whereas the components of the gel prefilter in accordancewith examples 169-210 preferably use two layers of needled non-woven, inaddition to a third layer of melt blown web. Further, the densities ofthe gel prefilter of examples 169-210 are substantially greater thanthose of examples 1-168, and the pore diameters are smaller.

In examples 187-199, shown in Table 18, the gel prefilter of examples1-168 was tested in combination with the microaggregate prefilter andthe adsorption elements of examples 169-186. By assembling thecombination into a test housing with t_(h) =0.372 cm, the gel prefilterelement was compressed to 0.09 cm, as in examples 1-168.

Examples 187-198 are thus identical with examples 169-186 with respectto the configuration of the microaggregate prefilter element and theadsorption element, and differ only with respect to their gelprefilters. The average age of the PRC used for testing is essentiallyequal for both, respectively 29.2 and 29.3 days. The gel prefilter ofexamples 169-186 showed only 1 of 12 clogged, for a 92% success ratio.Examples 187-198, which had been assembled with the gel prefilter ofexamples 1-168 showed five of twelve clogged for a 58% success ratio.The superiority of the gel prefilter of examples 169-186 for use witholder PRC is, therefore, clearly demonstrated.

Compared with examples 1-168, the pore diameter of the adsorptionelement of examples 169-198 is larger, with a preferred pore diameter inexcess of 6.5 micrometers; examples 1-168 show preferred ranges of porediameter in excess of 4, 5 and 5.5 micrometers respectively.

The effect of using smaller pore diameter adsorption elements on theability to successfully pass two units of older PRC is shown by examples199-210, shown in Table 19. These were prepared in the same manner asexamples 169-186, except that the preform comprising the microaggregateand adsorption elements was hot compressed to an average density of0.192 g/cc, and the adsorption element had a pore diameter in threetests of 5.1, 5.2 and 5.2 micrometers, which is in a preferred rangederived from examples 1-168 for use with fresher PRC.

The t_(h) setting of the housings used for examples 199-210 was adjustedsuch that the gel prefilter element was compressed at assembly to thesame thickness as in examples 169-186.

Average age of the PRC used in examples 199-210 was 29.2 days. The datashow that nine of twelve clogged, for a success ratio of 25%. Thiscompares with a ratio of 92% for examples 169-180, indicating thedesirability of the larger pore diameter of examples 169-186.Consequently, a preferred pore diameter range of this invention isgreater than 5.2 micrometers.

Insofar as the upper end of the range is concerned, it is believed thatthe pore diameter of the adsorption element could be increased to wellabove 10 micrometers while maintaining substantially equal efficiency;however, we have not explored the range above 8.2 micrometer diameterbecause of the undesirability of increasing the hold up volume for thebenefit (if any) of still fewer instances of clogging with very oldblood. Nevertheless, it should be understood that a device with poreopening larger than 8.2 micrometer, or larger than 10 micrometers, wouldfall within the scope of this invention.

Human blood, both intra- and extra-corporeal, will under somecircumstances form "rouleaux", a term applied to the condition in whichthe 7.5 micrometer diameter by 2 to 3 micrometer thick red cells adhereto each other in a geometric configuration resembling a roll of coins.Rouleaux tend to form in the human body as a result of viral infection,for example influenza, or the common cold, and some belief exists thatthe inability of rouleaux to pass through the smaller capillaries of thecirculatory system contributes to the muscle discomfort accompanyingthese infections. In the human body, capillaries less than 7.5micrometers in diameter under normal conditions pass red cells freely,as the individual cells deform readily. If older blood tends to formrouleaux, then this phenomenon may account for the larger pore diameterrequired to prevent clogging by older blood of the adsorption element ofthis invention.

Earlier in the application, it was stated that ". . . it has been widelyaccepted that the removal of leukocytes is accomplished by adsorption,rather than by filtration."

The disclosures of this invention confirm that leukocytes are removed byadsorption, but also lead to the discovery that, particularly forrelatively recently drawn PRC, they can be removed with equal or greaterefficiency and with reduced blood loss due to hold-up by a combinationof adsorption and filtration, provided that the pore size of the lastelement of the device is in the preferred diameter range and thatadequate prefiltration has been provided to prevent gels,microaggregates and other components present in the PRC when it isreceived from the blood bank from reaching the last element.

                                      TABLE A                                     __________________________________________________________________________    A      B     C   D   E   F  G          I                                      Example                                                                              Component                                                                           A.sub.f                                                                           P,  t,  A.sub.t,                                                                         Av. Fiber                                                                           H    CWST, J                                Number Sequence                                                                            M.sup.2 /g                                                                        g/cc                                                                              cm  M.sup.2                                                                          Dia, μm                                                                          Dp (μm)                                                                         Dynes/cm                                                                            Remarks                          __________________________________________________________________________    1-18   1     0.13                                                                              0.10                                                                              .090                                                                              .08                                                                              23    50.sup.(1)                                                                         50.sup.(2)                                                                          Total surface area for           (Table 1)                                                                            2a    0.19        .09                                                                              15               the five elements in                    2b    0.29                                                                              0.30                                                                              .076                                                                              .14                                                                              10    15   52.sup.(2)                                                                          the adult size device                   2c    0.41        0.19                                                                             7                is 3.29 square                                                                meters.sup.(3)                          3     0.64                                                                              0.20                                                                              .064                                                                              0.51                                                                             4.5   13   52.sup.(2)                                    4     0.64                                                                              0.23                                                                              .056                                                                              0.51                                                                             4.5    9   52.sup.(2)                                    5     0.99                                                                              0.167                                                                             0.152                                                                             1.77                                                                             2.6    6.1 52.sup.(2)                             19-57                                        See text                         (Tables                                                                       2 to 8)                                                                       58-65  1     0.13                                                                              0.10                                                                              .090                                                                              .08                                                                              23    50.sup.(1)                                                                         50.sup.(2)                                                                          Total surface area of            (Table 9)                                                                            2a    0.19        .09                                                                              15               five elements in the                    2b    0.29                                                                              .30 .076                                                                              .14                                                                              10    15   59    adult size device is                    2c    0.41        0.19                                                                             7                4.07 square meters.sup.(3)              3     0.64                                                                              0.20                                                                              .064                                                                              0.51                                                                             4.5   13   59                                            4     0.64                                                                              0.23                                                                              .056                                                                              0.51                                                                             4.5    9   59                                            5     1.77                                                                              0.252                                                                             .251                                                                              2.55                                                                             4.5    6.9 59                                     66-73  1     0.13                                                                              0.10                                                                              .090                                                                              .08                                                                              23    50.sup.(1)                                                                         50.sup.(2)                                                                          Total surface area of            (Table 9)                                                                            2a    0.19        .09                                                                              15               five elements in the                    2b    0.29                                                                              0.30                                                                              .076                                                                              .14                                                                              10    15   59    adult size device is                    2c    0.41        0.19                                                                             7                4.07 square meters                      3     0.64                                                                              0.18                                                                              .069                                                                              0.51                                                                             4.5   15   59                                            4     0.64                                                                              0.21                                                                              .061                                                                              0.51                                                                             4.5   12   59                                            5     1.77                                                                              0.229                                                                             0.277                                                                             2.55                                                                             4.5    7.4 59                                     74-95                                        See text                         (Tables                                                                       11, 12 and 14)                                                                96-101 1     0.13                                                                              0.10                                                                              .090                                                                              .08                                                                              23    50.sup.(1)                                                                         50.sup.(2)                                                                          *      t  Dp                     (Table 15)                                                                           2a    0.19        .09                                                                              15                96 0.270 0.145 6.6                     2b    0.29                                                                              0.30                                                                              .076                                                                              .14                                                                              10    15   59     97 0.270 0.145 6.6                     2c    0.41        0.19                                                                             7                 98 0.280 0.137 6.1                     3     0.64                                                                              0.18                                                                              .069                                                                              0.51                                                                             4.5   15   59     99 0.280 0.137 6.1                     4     0.64                                                                              0.21                                                                              .061                                                                              0.51                                                                             4.5   12   59    100 0.296 0.130 5.6                     5     0.83                                                                              *   *   1.53                                                                             4.5   *    59    106 0.299 0.130 5.6                                                           Total surface area of                                                         5 elements = 3.13M.sup.2(3)      102-106                                      See text                         (Table 13)                                                                                                                       Rev.                       __________________________________________________________________________                                                       (b)                         .sup.(1) Estimated Microscopically                                            .sup.(2) Surfaces Not Modified                                                .sup.(3) For Adult Size Device                                           

                                      TABLE I                                     __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                  Leukocytes              Total Fluid                                                                              No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood    Bag Count                                                                           in Effluent             Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             No. WBC   % Re-               No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                            End cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                           No/μl                                                                          moval               __________________________________________________________________________    1    245                                                                              150                                                                              1  4  80  20   12.5                                                                             40  .3          1  6000  0   100                                                              2  --    --  --                  *2   652                                                                              0  2  5  80  20   11 40  4           1  4950  0   100                                                              2  3000  170 94.3                3    297                                                                              0  1  3  74  19   8.5                                                                              17.5                                                                              2           1  6850  0   100                                                              2  5500  100 99.2                4    243                                                                              0  1  4  75  21   12 22  2           1  11600 0   100                                                              2  10500 50  99.5                5    344                                                                              0  1  26 80  25   16.5                                                                             21  2           1  2050  0   100                                                              2  1350  50  96.7                6    371                                                                              0  1  26 80  19   13 18.5                                                                              2           1  2100  0   100                                                              2  1650  0   100                 7    319                                                                              0  1  14 72  28   15 40  1.8         1  4200  0   100                                                              2  2350  75  96.8                8    320                                                                              144                                                                              1  14 80  18   18 40  0.49        1  6350  0   100                                                              2  10950 150 99.6                9    315                                                                              0  1  6  78  19   12.5                                                                             34  2           1  1350  0   100                                                              2  1450  0   100                 *10  631                                                                              0  2  8  78  25   11 25.5                                                                              4           1  2450  0   100                                                              2  1800  0   100                 11   296                                                                              107                                                                              1  5  85  18   13.5                                                                             40  0.47        1  3150  0   100                                                              2  2050  0   100                 12   337                                                                              0  1  6  76  16   10 40  2           1  6550  0   100                                                              2  5600  200 96.4                13   308                                                                              0  1  15 79  17   10.5                                                                             34  2           1  3350  0   100                                                              2  3000  75  97.5                *14  658                                                                              0  2  17 80  69   21 40  3.6         1  1900  0   100                                                              2  3850  25  99.4                15   280                                                                              0  1  10 76  17   10.5                                                                             29.5                                                                              2     19.4  1  2150  0   100                                                              2  1850  0   100                 16   302                                                                              87 1  14 76  14   13 40  0.47  19.4  1  2750  0   100                                                              2  2600  25  99                  17   343                                                                              0  1  14 76  13   11.5                                                                             40  2     19.4  1  3100  0   100                                                              2  2750  25  99.1                *18  577                                                                              254                                                                              2  14 85  20   14 40  0.95  34.2  1  2900  0   100                                  85                          2  4500  50  98.9                __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                                      TABLE 2                                     __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                  Leukocytes              Total Fluid                                                                              No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood    Bag Count                                                                           in Effluent             Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             No. WBC   % Re-               No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                           No/μl                                                                          moval               __________________________________________________________________________    *19  575                                                                              0  2  19 75  16   13.5                                                                              40 4           1  1600  0   100                                                              2  1350  0   100                 20   219                                                                              0  1  27 82  33   22.5                                                                              38 2           1  1250  0   100                                                              2  1400  0   100                 21   271                                                                              0  1  27 75  24   20  40 2           1  1550  0   100                                                              2  2000  0   100                 22   275                                                                              0  1  19 65  12   9   29 2           1  2400  0   100                                                              2  2500  0   100                 23   288                                                                              0  1   2 71  12   3.5 17 2     20.7  1  7750  0   100                                                              2  8150  150 98                  24   273                                                                              0  1   2 75  12   7   40 1.9   20.8  1  5500  0   100                                                              2  4650  0   100                 25   209                                                                              0  1   2 75  10   7.5 12 2     21.0  1  7950  0   100                                                              2  10150 0   100                 *26  561                                                                              0  2  17 79  33   23.5                                                                              40 3     36.1  1  2400  0   100                                                              2  1850  0   100                 27   320                                                                              0  1  15 75  12   14.5                                                                              28 2           1   500  0   100                                                              2   700  0   100                 28   360                                                                              0  1  15 75  10   12.5                                                                              40 1.7         1  3500  0   100                                                              2  3400  0   100                 29   295                                                                              0  1  19 80  33   10  31 2           1  2000  0   100                                                              2  2200  0   100                 30   268                                                                              0  1  19 79  16   10  31 2           1  1900  0   100                                                              2  2800  0   100                 31   254                                                                              0  1  20 83  16   10  17.5                                                                             2           1   950  0   100                                                              2  1600  0   100                 *32  526                                                                              0  2  18 81  18   14  40 3.7         1  3200  0   100                                                              2  1450  0   100                 *33  729                                                                              0  2   9 67  12   11.5                                                                              23.5                                                                             4     36.1  1  1900  0   100                                  71                          2  2250  20  99.1                *34  620                                                                              0  2  10 75  15   11.5                                                                              40 4     36.1  1  2100  0   100                                  78                          2  3150  20  99.4                __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                                      TABLE 3                                     __________________________________________________________________________    *Blood Bag Data      Fluid Flow Data                  Leukocytes              Total Fluid                                                                              No.   Hema-                                                                             Primimg                                                                            Pressure                                                                             End Flow                                                                            Blood    Bag Count                                                                           in Effluent             Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             No. WBC   % Re-               No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                           No/μl                                                                          moval               __________________________________________________________________________    35   560                                                                              142                                                                              1   3 45  <6   5.5 40 .46   21    1  3050  0   100                                                              2  3500  300 91.4                36   462                                                                              57 1   3 44  <6   6.5 40 .49   21    1  2900  0   100                                                              2  2900  300 89.7                37   519                                                                               0 1  15 47  <6   8.0 24.5                                                                             2     21    1   600  0   100                                                              2   500  0   100                 38   557                                                                               0 1  15 50  <6   4.5 16.5                                                                             2     21    1  1750  0   100                                                              2  1700  0   100                 __________________________________________________________________________     *Whole Blood                                                             

                                      TABLE 4                                     __________________________________________________________________________    *Blood Bag Data      Fluid Flow Data                  Leukocytes              Total Fluid                                                                              No.   Hema-                                                                             Primimg                                                                            Pressure                                                                             End Flow                                                                            Blood    Bag Count                                                                           in Effluent             Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             No. WBC   % Re-               No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                           No/μl                                                                          moval               __________________________________________________________________________    39   249                                                                               0 1  2  76  21   12.5                                                                              32.5                                                                             2     20.4  1  6200  0   100                                                              2  5350  0   100                 40   271                                                                              78 1  2  80  20   11.5                                                                              40 .45   21.3  1  7200  0   100                                                              2  7000  0   100                 41   317                                                                              27 1  9  71  17   10.5                                                                              40 .46   22.2  1  3950  0   100                                                              2  3500  0   100                 *42  604                                                                              95 2  9  73  27   17.5                                                                              40 .97   36.1  1  4650  0   100                                  75                          2  5000  150  97                 __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                                      TABLE 5                                     __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                  Leukocytes              Total Fluid                                                                              No.   Hema-                                                                             Primimg                                                                            Pressure                                                                             End Flow                                                                            Blood    Bag Count                                                                           in Effluent             Example                                                                            Weight, G                                                                           Bags                                                                              Age,                                                                            tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             No. WBC   % Re-               No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                           No/μl                                                                          moval               __________________________________________________________________________     43  308                                                                              0  1  2  66  10   7.5 15.5                                                                             2     21    1  7300   0  100                                                              2  7100  350 95.1                *44  640                                                                              0  2  2  70  13   11  26 4     36    1  3900   0  100                                                              2  5650  530 91.6                __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                                      TABLE 6                                     __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                   Leukocytes             Total Fluid                                                                              No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood     Bag Count                                                                           in Effluent            Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                              No. WBC   % Re-              No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No. per μl                                                                           No/μl                                                                          moval              __________________________________________________________________________    *45  526                                                                              0  2   4 77  36   13  26 4     36.1  1   5550  0   100                                 76                          2   2900  20  99.3               46   273                                                                              0  1  11 76  23   13.5                                                                              40 1.7   20.4  1   6150  50  99.2                                                            2   7800  650 91.7               47   271                                                                              76 1  15 86  26   31.5                                                                              40 0.49  20.4  1   5300  0   100                                                             2   6250  0   100                48   286                                                                              0  1  27 75  26   14  40 2.0   19.4  1   1200  0   100                                                             2   1000  0   100                __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                                      TABLE 7                                     __________________________________________________________________________    Blood Bag Data        Fluid Flow Data                  Leukocytes             Total Fluid No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood    Bag Count                                                                           in Effluent            Example                                                                            Weight, G                                                                            Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             No. WBC   % Re-              No.  Start                                                                            End Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                           No/μl                                                                          moval              __________________________________________________________________________    49   313                                                                              173 1  14 78  12   15.5                                                                              40 .43   18    1  2500  0   100                        116**                                                                 50   338                                                                              249 1  14 78  17   40  40 .44   16    1  3000  0   100                         46**                                                                 51   252                                                                              195 1  14 80  17   40  40 .47   14    1  2300  0   100                         35**                                                                 52   290                                                                              231 1  14 76  13   40  40 .44   11    1  2500  0   100                          34**                                                                __________________________________________________________________________     **Volume collected downstream of the filter.                             

                                      TABLE 8                                     __________________________________________________________________________                                                  Bag                             Ex-                                                                              Blood Bag Data  Fluid Flow Data            Count                                                                             Leukocytes                                                                            Thick-              am-                                                                              Total Fluid                                                                         No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood    No. in Effluent                                                                           ness                ple                                                                              Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                             WBC     %                                                                                 Layer 1,            No.                                                                              Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No.                                                                              per μl                                                                         No/μl                                                                          moval                                                                             mm                  __________________________________________________________________________    53 294                                                                               67                                                                              1  15 83  22   12.5                                                                              40 0.49  18.5  1  2700                                                                              0   100 0.56                                                           2  2850                                                                              0   100                     54 346                                                                              0  1  15 69  15   11  40 2     19.9  1  3100                                                                              0   100 0.48                                                           2  3900                                                                              0   100                     55 278                                                                              0  1  15 82  23   18.5                                                                              40 1.8   19.4  1  5800                                                                              25  99.6                                                                              0.41                                                           2  4200                                                                              450 89.3                    *56                                                                              592                                                                              234                                                                              2  15 78  27   23  40 0.98  32.4  1  4650                                                                              0   100 0.36                               80                          2  2050                                                                              0   100                     __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                                      TABLE 9                                     __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                   Leukocytes             Total Fluid                                                                              No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood     Bag Count                                                                           in Effluent            Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit                                                                            Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                              No. WBC   % Re-              No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No. per μl                                                                           No/μl                                                                          moval              __________________________________________________________________________    58   328                                                                              0  1  19 73  11   8.5 5.5                                                                              2     20.6  1   5450  0   100                                                             2   4600  25  99.5               *59  528                                                                              0  2  14 72  20   14.5                                                                              39 4     38.6  1   1600  0   100                              14 76                          2   1750  50  97.1               *60  511                                                                              0  2  19 76  20   23.5                                                                              23.5                                                                             4     39    1    750  0   100                              19 76                          2   2150  0   100                61   309                                                                              0  1  19 72  13   9   17 2     22.4  1   2150  0   100                                                             2   2500  50  98                 62   350                                                                              0  1  17 70  14   14  21 2     23.4  1   1800  0   100                                                             2   1500  0   100                *63  671                                                                              0  2  20 80  15   14.5                                                                              27.5                                                                             4     40    1    850  0   100                              21 80                          2   2200  25  98.9               64   371                                                                              0  1  16 70  11   14  24.5                                                                             2     22.2  1   1800  0   100                                                             2   2200  0   100                65   294                                                                              0  1  16 70  15   12  16 2     23    1   1300  0   100                                                             2   1500  0   100                66   280                                                                              0  1  18 79  14   11  20 2     24    1   3850  0   100                                                             2   4050  750 81.5               67   310                                                                              0  1  18 79   9   11  13 2     24.5  1   2750  0   100                                                             2   2000  0   100                68   339                                                                              0  1  17 75  14   11  40 1.9   23.3  1   3000  0   100                                                             2   3000  350 88.3               69   362                                                                              0  1  17 73  12   8.5 11 2     24.8  1   2100  0   100                                                             2   2200  300 86.4               70   346                                                                              0  1  17 75  11   9.5 40 1.9   24.5  1   2850  0   100                                                             2   2250  0   100                71   347                                                                              0  1  16 73  19   16.5                                                                              40 1.8   23    1   2700  0   100                                                             2   1800  100 94.4               72   354                                                                              0  1  16 75  13   9   26 2     24.4  1   2300  0   100                                                             2   1300  0   100                73   322                                                                              80 1  16 75  32   24.5                                                                              40 .47   25.1  1   1700  0   100                                                             2   1800  0   100                __________________________________________________________________________     *Adult size device. All others are pediatric size.                       

                  TABLE 10                                                        ______________________________________                                                       Example Numbers                                                               19-34 96-97   58-65   66-73                                    ______________________________________                                        DOWN-    Fiber Diameter                                                                            2.6     4.5   4.5   4.5                                  STREAM   micrometers,                                                         ELEMENT  Thickness, cm                                                                             0.152   0.145 0.251 0.277                                DATA     Density, g/cc                                                                             0.167   0.270 0.252 0.229                                         Pore Diameter                                                                             6.1     6.6   6.9   7.4                                           micrometers                                                                   Surface Area,                                                                             3.29    3.13  4.07  4.07                                          Square Meters                                                        No. of tests failing to pass                                                                   0       0       0     1                                      two units                                                                     Average efficiency for first                                                                   100     100     100   100                                    unit, %                                                                       Average efficiency for second                                                                  99.9    100     99.2  95.1                                   unit, %                                                                       Average hold up volume of                                                                      20.8    20.4    22.3  24.2                                   pediatric device, ml                                                          Average hold up volume of the                                                                  36.1    35.7*   39.2  43.3*                                  adult size device, cc                                                         Volume of the fibrous                                                                          27.1    26.6    33.3  35.5                                   elements, cc                                                                  ______________________________________                                         *Estimated datum                                                         

                                      TABLE 11                                    __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                   Leukocytes             Total Fluid                                                                              No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood     Bag Count                                                                           in Effluent            Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Haed, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                              No. WBC   % Re-              No.  Start                                                                            End                                                                              Used                                                                             days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No. per μl                                                                           No/μl                                                                          moval              __________________________________________________________________________    74   626                                                                               0 2   4 71  21   19.5                                                                              40 3.8   31.5  1   4700  0   100                                 74                          2   16150 40  99.7               75   614                                                                              171                                                                              2   9 74  42   19  40 0.97  31.5  1   3100  0   100                                 68                          2   2950  0   100                76   567                                                                              116                                                                              2  15 76  34   11  40 0.98  31.5  1   4500  0   100                                 75                          2   6350  25  99.6               77   572                                                                              188                                                                              2  18 78  45   29.5                                                                              40 0.98  31.5  1   1800  0   100                                 76                          2   1300  0   100                78   304                                                                               3 1  34 80  92   40  40 0.96  31.5  1   1900  0   100                __________________________________________________________________________

                                      TABLE 12                                    __________________________________________________________________________    Blood Bag Data       Fluid Flow Data                   Leukocytes             Total Fluid                                                                              No.   Hema-                                                                             Priming                                                                            Pressure                                                                             End Flow                                                                            Blood     Bag Count                                                                           in Effluent            Example                                                                            Weight, G                                                                           Bags                                                                             Age,                                                                             tocrit,                                                                           Time Head, Inches                                                                         Rate, Hold-Up                                                                             Unit                                                                              No. WBC   % Re-              No.  Start                                                                            End                                                                              Used                                                                             Days                                                                             %   Sec. Start                                                                             End                                                                              cc/min                                                                              Volume, cc                                                                          No. per μl                                                                           No/μl                                                                          moval              __________________________________________________________________________    79   353                                                                              0  1  18 62  7    5.5 13 2     21.6  1    700  0   100                                                             2    800  0   100                80   311                                                                              0  1  18 57  6    8   12.5                                                                             2     22.3  1   1800  0   100                                                             2   1750  0   100                81   374                                                                              0  1  19 58  7    5   15.5                                                                             2     22.7  1   1350  0   100                                                             2   1500  0   100                82   383                                                                              0  1  19 60  6    7.5 13.5                                                                             2     22.2  1    750  0   100                                                             2    950  0   100                83   339                                                                              0  1  25 61  8    10  12 2     22.4  1   1500  0   100                                                             2   1100  0   100                84   339                                                                              0  1  25 56  8    9   17.5                                                                             2     22.4  1   2300  0   100                                                             2   2000  0   100                85   438                                                                              0  1  25 56  5    7.5 40 .86   21.5  1   1250  0   100                                                             2   1150  0   100                __________________________________________________________________________

                  TABLE 13                                                        ______________________________________                                        Example                                                                              Density,   Thickness,                                                                              % of Tests                                                                              F2 Pore                                 No.    g/cc       cms       Clogged   dia, μm                              ______________________________________                                         102*  0.17       0.152     0         6.1                                     103    0.19       0.137     0         4.7                                     104    0.21       0.124     0         4.2                                     105    0.23       0.112     25        3.8                                     106    0.25       0.102     50        3.6                                     ______________________________________                                         *Average of the data of examples 19-34.                                  

                                      TABLE 14                                    __________________________________________________________________________                                                  Leukocytes                      Blood Bag Data     Fluid Flow Data        Bag in Effluent                     Ex-             He-     Pressure                                                                            End Blood   Count   %                           am-                                                                              Total Fluid                                                                          No.   mat-                                                                             Priming                                                                            Head, Flow                                                                              Hold-Up No.     Re-    Thick                                                                            Pore              ple                                                                              Weight, G                                                                            Bags                                                                             Age,                                                                             ocrit,                                                                           Time  Inches                                                                             Rate,                                                                             Volume,                                                                            Unit                                                                             WBC     mov-                                                                             Density                                                                           ness,                                                                            Dia.              No.                                                                              Start                                                                            End Used                                                                             Days                                                                             %  Sec. Start                                                                            End                                                                              cc/min                                                                            cc   No.                                                                              per μl                                                                         No/μl                                                                          al g/cc                                                                              mm μm             __________________________________________________________________________    86 293                                                                              26  1   3 77 13   10 40 0.48                                                                              24.9 1  6500                                                                              850 87 0.117                                                                             2.24                                                                             7                                                        2  4500                                                                              2550                                                                              43.3                        87 267                                                                              0   1   3 79 14   8  13 2   23.1 1  5300                                                                              300 94.5                                                                             0.128                                                                             2.03                                                                             6.7                                                      2  4200                                                                              1000                                                                              74.2                        88 315                                                                              0   1   3 78 12   7  10 2   21.9 1  7200                                                                              450 93.7                                                                             0.142                                                                             1.85                                                                             6.5                                                      2  5500                                                                              1850                                                                              66.4                        89 273                                                                              21  1   3 76 13   10.5                                                                             40 0.47                                                                              20.6 1  11050                                                                             200 99.2                                                                             0.157                                                                             1.68                                                                             6.3                                                      2  9350                                                                              2600                                                                              72.2                        90 287                                                                              0   1-2                                                                              15 76 18   12.5                                                                             32 1.7-4                                                                             20.8-36.1                                                                          1  2900                                                                              0   100                                                                              0.167                                                                             .152                                                                             6.1                                                      2  3100                                                                              12  99.6                        91 317                                                                              164 1  15 75 25   40 40 0.48                                                                              20.4 1  3550                                                                              0   100                                                                              0.173                                                                             1.45                                                                             6.0                                                      2  3450                                                                              0   100                         92 337                                                                              0   1  19 79 22   16 31.5                                                                             0.84                                                                              20.4 1  2600                                                                              0   100                                                                              0.180                                                                             1.45                                                                             5.9                                                      2  2600                                                                              0   100                         93 292                                                                              147 1  21 84 36   39 40 0.49                                                                              20.4 1  1400                                                                              0   100                                                                              0.180                                                                             1.45                                                                             5.9               94 281                                                                              36  1  15 75 14   14 40 0.49                                                                              20.4 1  4900                                                                              0   100                                                                              0.183                                                                             1.37                                                                             5.9                                                      2  5450                                                                              0   100                         95 283                                                                              0   1  15 76 27   18.5                                                                             40 1.5 20.4 1  2700                                                                              0   100                                                                              0.196                                                                             1.30                                                                             5.7                                                      2  3150                                                                              0   100                         __________________________________________________________________________

                                      TABLE 15                                    __________________________________________________________________________                                                  Leukocytes                      Blood Bag Data     Fluid Flow Data        Bag in Effluent                     Ex-             He-     Pressure                                                                            End Blood   Count   %                           am-                                                                              Total Fluid                                                                          No.   mat-                                                                             Priming                                                                            Head, Flow                                                                              Hold-Up No.     Re-    Thick                                                                            Pore              ple                                                                              Weight, G                                                                            Bags                                                                             Age,                                                                             ocrit,                                                                           Time  Inches                                                                             Rate,                                                                             Volume,                                                                            Unit                                                                             WBC     mov-                                                                             Density                                                                           ness,                                                                            Dia.              No.                                                                              Start                                                                            End Used                                                                             Days                                                                             %  Sec. Start                                                                            End                                                                              cc/min                                                                            cc   No.                                                                              per μl                                                                         No/μl                                                                          al g/cc                                                                              cm μm             __________________________________________________________________________    96 239                                                                              0   1  22 82 17   16 40 1.6 20.4 1  1700                                                                              0   100                                                                              0.270                                                                             0.145                                                                            6.6                                                      2  1600                                                                              0   100                         97 343                                                                              0   1  16 70  7   6  27.5                                                                             2   20.5 1  1550                                                                              0   100                                                                              0.270                                                                             0.145                                                                            6.6                                                      2  1000                                                                              0   100                         98 240                                                                              0   1  16 79 12   13 32.5                                                                             2   20.6 1   950                                                                              0   100                                                                              0.280                                                                             0.137                                                                            6.1                                                      2   950                                                                              0   100                         99 286                                                                              62  1  22 86 24   15 40 0.49                                                                              19.1 1  1600                                                                              0   100                                                                              0.280                                                                             0.137                                                                            6.1                                                      2  1600                                                                              0   100                         100                                                                              335                                                                              0   1  16 74 12   7.5                                                                              19 2   20.6 1  1850                                                                              0   100                                                                              0.296                                                                             0.130                                                                            5.6                                                      2  1800                                                                              0   100                         101                                                                              343                                                                              0   1  16 75  8   8  16 2   20.4 1  1300                                                                              0   100                                                                              0.299                                                                             0.130                                                                            5.6                                                      2  1150                                                                              0   100                         __________________________________________________________________________

                  TABLE 16                                                        ______________________________________                                        1       2         3       4     5                                             Example CWST      Number of units passed prior to                             Numbers dynes/cm  clogging                                                    ______________________________________                                                          0       1      2 (no clogging)                              107-119 52        1       3      9                                            119-125 63        0       3     12                                            126-140 75        1       0     14                                            141-156 87        0       0     16                                            157-168 109       0       1     11                                            ______________________________________                                    

                                      TABLE 17                                    __________________________________________________________________________    PRC DATA                                                                      Volume    Volume                                                                              Hemato-                                                                             Age,                                                                              Priming                                                                            LEUKOCYTE COUNT                                                                            LEUKOCYTE                         Example                                                                            of Two                                                                             Remaining                                                                           crit, %                                                                             Days                                                                              Time,                                                                              Bag    Filtrate                                                                            EFFICIENCY, %                     No.  Bags, cc                                                                           cc    #1 #2 #1                                                                              #2                                                                              Seconds                                                                            1   2  1 2   1    2                            __________________________________________________________________________    169  530  0     73 80 24                                                                              24                                                                              20   50  50 0 0   *    *                            170  519  22    76 75 24                                                                              24                                                                              19   0   0  0 25  *    *                            171  655  20    78 70 24                                                                              24                                                                              17   50  50 0 0   *    *                            172  575  0     75 64 24                                                                              24                                                                              20   0   100                                                                              0 0   *    *                            173  599  0     73 75 24                                                                              24                                                                              15   50  150                                                                              0 0   *    *                            174  618  0     70 59 24                                                                              24                                                                              14   0   100                                                                              0 0   *    *                            175  612  0     62 71 35                                                                              34                                                                              15   50  250                                                                              0 0   *     100                         176  594  0     76 76 35                                                                              33                                                                              21   300 100                                                                              0 0   100  *                            177  582  0     60 65 35                                                                              34                                                                              19   150 50 0 0   *    *                            178  555  0     63 70 35                                                                              33                                                                              23   0   150                                                                              0 0   *    *                            179  475  0     70 74 35                                                                              35                                                                              20   300 50 0 0   100  *                            180  500  100   76 71 35                                                                              35                                                                              20   100 150                                                                              0 0   *    *                            181  620  0     78 75  2                                                                               2                                                                              18   6600                                                                              3700                                                                             0 150 100  96.0                         182  590  0     75 75  2                                                                               2                                                                              21   13500                                                                             7950                                                                             0 75  100  99.1                         183  565  0     75 74  2                                                                               2                                                                              18   4100                                                                              6400                                                                             0 0   100  100                          184  560  0     75 69  2                                                                               2                                                                              16   7500                                                                              4900                                                                             0 25  100  99.5                         185  535  0     75 77  2                                                                               2                                                                              17   6700                                                                              4800                                                                             0 25  100  99.5                         186  600  0     75 75  2                                                                               2                                                                              16   5700                                                                              4450                                                                             0 25  100  98.9                         __________________________________________________________________________     *Bag counts too low to provide significant efficiency data.              

                                      TABLE 18                                    __________________________________________________________________________    PRC DATA                                                                      Volume    Volume                                                                              Hemato-                                                                            Age,                                                                              Priming                                                                            LEUKOCYTE COUNT                                                                           LEUKOCYTE                           Example                                                                            of Two                                                                             Remaining                                                                           crit, %                                                                            Days                                                                              Time,                                                                              Bag   Filtrate                                                                            EFFICIENCY, %                       No.  Bags, cc                                                                           cc    #1 #2                                                                              #1                                                                              #2                                                                              Seconds                                                                            1  2  1  2  1    2                              __________________________________________________________________________    187  557  50    84 78                                                                              23                                                                              23                                                                              19    50                                                                              100                                                                              0  0  *    *                              188  551  12    86 76                                                                              23                                                                              27                                                                              23   100                                                                              350                                                                              0  0  *    100                            189  600  124   79 69                                                                              23                                                                              27                                                                              18   150                                                                              250                                                                              0  0  *    *                              190  536  86    88 72                                                                              23                                                                              27                                                                              24   150                                                                              150                                                                              0  0  *    *                              191  548  0     75 79                                                                              23                                                                              27                                                                              12    50                                                                              100                                                                              0  0  *    *                              192  647  57    79 60                                                                              23                                                                              27                                                                              14    50                                                                               50                                                                              0  0  *    *                              193  653  0     68 70                                                                              35                                                                              35                                                                              24   150                                                                               50                                                                              0  0  *    *                              194  579  0     75 70                                                                              31                                                                              35                                                                              13   100                                                                              150                                                                              0  0  *    *                              195  641  0     70 76                                                                              31                                                                              35                                                                              18    50                                                                               50                                                                              0  0  *    *                              196  550  0     79 75                                                                              31                                                                              35                                                                              18    50                                                                               0 0  0  *    *                              197  601  375   78 79                                                                              35                                                                              35                                                                              23   100                                                                               50                                                                              0  0  *    *                              198  587  0     72 73                                                                              35                                                                              35                                                                              20   150                                                                              100                                                                              0  0  *    *                              __________________________________________________________________________     *Bag counts too low to provide significant efficiency data.              

                                      TABLE 19                                    __________________________________________________________________________    PRC DATA                                                                      Volume    Volume                                                                              Hemato-                                                                            Age,                                                                              Priming                                                                            LEUKOCYTE COUNT                                                                            LEUKOCYTE                          Example                                                                            of Two                                                                             Remaining                                                                           crit, %                                                                            Days                                                                              Time,                                                                              Bag     Filtrate                                                                           EFFICIENCY, %                      No.  Bags, cc                                                                           cc    #1 #2                                                                              #1                                                                              #2                                                                              Seconds                                                                            1   2   1  2 1    2                             __________________________________________________________________________    199  537  127   81 78                                                                              35                                                                              35                                                                              34   0   50  0  0 *    *                             200  576  253   72 76                                                                              35                                                                              35                                                                              23   250 0   0  0 100  *                             201  642  239   49 65                                                                              35                                                                              35                                                                              22   0   50  0  0 *    *                             202  577  289   71 81                                                                              35                                                                              35                                                                              20   50  0   0  0 *    *                             203  543  0     68 70                                                                              35                                                                              35                                                                              17   0   0   0  0 *    *                             204  633  278   72 70                                                                              35                                                                              35                                                                              19   0   0   0  0 *    *                             205  642  0     70 70                                                                              25                                                                              25                                                                              18   150 100 0  0 *    *                             206  587  39    78 80                                                                              25                                                                              27                                                                              21   0   50  0  0 *    *                             207  571  106   76 81                                                                              27                                                                              23                                                                              17   50  50  0  0 *    *                             208  637  0     70 74                                                                              26                                                                              24                                                                              15   50  100 0  0 *    *                             209   377**                                                                             19**  77 77                                                                              27                                                                              27                                                                              24   100 --  0  0 *    *                             210  529  101   72 85                                                                              27                                                                              23                                                                              20   150 200 0  0 *    *                             __________________________________________________________________________     *Bag count too low to provide significant efficiency data.                    **Did not complete first bag.                                            

I claim:
 1. A device for separating one or more substances from a fluidto be administered to a patient, the device comprising a housingincluding an inlet and an outlet and defining a fluid flow path betweenthe inlet and the outlet and a separating element disposed within thehousing across the fluid flow path and including a downstream surface,wherein the inlet communicates with the housing near the bottom of thehousing and upstream from the separating element and wherein the housingincludes a wall facing the downstream surface of the separating elementand defining a plenum and a slot disposed in the wall and communicatingbetween the plenum and the outlet for allowing air in the fluid toseparate from the fluid, said outlet being located near the top of thehousing.
 2. The device of claim 1 wherein the slot is deeper than theplenum.
 3. The device of claim 2 wherein the wall includes a pluralityof concentric circular grooves which communicate with the slot.
 4. Thedevice of claim 3 wherein the slot extends from the bottom to the top ofthe housing.
 5. The device of claim 2 wherein the slot length is 50 to80% of an inner diameter of the housing, and the slot extends to the topof the housing.
 6. The device of claim 5 wherein the slot depthincreases towards the top of the housing.
 7. The device of claim 2wherein the housing has a generally circular configuration and the slotextends from the top of the housing along at least a portion of thelength of the vertical inner diameter of the housing.
 8. The device ofclaim 1 wherein the slot extends from the bottom to the top of thehousing.
 9. A method for the depletion of the leukocyte content of bloodproduct comprising passing the blood product through the device ofclaim
 1. 10. A device for separating one or more substances from a fluidto be administered to a patient, the device comprising a generallycylindrical housing including an inlet and an outlet and defining afluid flow path between the inlet and the outlet and a disc shapedseparation element disposed within the housing and having upstream anddownstream surfaces, wherein the housing further includes an inletsection facing the upstream surface of the separating element anddefining an inlet plenum, the inlet including a ridge extendingvertically along the exterior of the inlet section and a firstpassageway which opens at the top of the inlet ridge, extends throughthe inlet ridge, and communicates with the inlet plenum at the bottom ofthe housing, and an outlet section facing the downstream surface of theseparating element and defining an outlet plenum and including a slotwhich is deeper than the outlet plenum and which communicates betweenthe outlet plenum and the outlet, the outlet including a ridge extendingvertically along the exterior of the outlet section and a secondpassageway which opens at the bottom of the outlet ridge, extendsthrough the outlet ridge, and communicates with the slot near the top ofthe housing.
 11. The device of claim 10 wherein the inlet sectionincludes a plurality of concentric circular grooves and an accessextending between the inlet passageway and each circular groove, thecircular grooves and the access collectively defining the inlet plenumand the inlet plenum having a depth which is greatest at the bottom ofthe housing near the inlet passageway.
 12. The device of claim 10wherein the outlet section includes a plurality of concentric circulargrooves which communicate with the slot and wherein the slot extendsfrom near the bottom of the housing to the top of the housing and has agreater depth at the top of the housing than at the bottom.
 13. Thedevice of claim 10 wherein the housing further includes a cylindricalcollar disposed about the periphery of the disc shaped separationelement, the disc shaped separation element being sealed to thecylindrical collar by an interference fit between them.
 14. A method forthe depletion of the leukocyte content of blood product comprisingpassing the blood product through the device of claim 10.